MEDICARE: COLLINS FAMILY PLANNING CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0005X	Ambulatory Family Planning Facility	444821	TX

General Provider Information

NPI Number	:	1457804593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLLINS FAMILY PLANNING CLINIC

Provider Business Mailing Address
First Line	:	1100 BRIDGEWOOD DR STE 120
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-0809
Country	:	US
Telephone Number	:	817-922-8182
Fax Number	:	866-638-4872

Provider Business Practice Location Address
First Line	:	1100 BRIDGEWOOD DR STE 120
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-0809
Country	:	US
Telephone Number	:	817-922-8182
Fax Number	:	866-638-4872

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. JANICE MARIA BROWN
Credential	:	APRN, WHNP-BC
Telephone Number	:	817-922-8182

Provider Enumeration Date	:	07/25/2016
Last Update Date	:	02/28/2025

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