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NPI Code Detail

MEDICARE: MR. JOE DAVID COLLINS

MEDICARE: MR. JOE DAVID COLLINS
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
1101YM0800XMental Health Counselor19551TX

General Provider Information

NPI Number : 1588871503
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOE DAVID COLLINS
Provider Business Mailing Address
First Line : 8001-E NORTH MESA
Second Line : B 162
City : EL PASO
State : TX
Zip : 79932
Country : US
Telephone Number : 915-549-2868
Fax Number : 915-833-3227
Provider Business Practice Location Address
First Line : 1418 MONTANA AVE
Second Line :
City : EL PASO
State : TX
Zip : 79902-5618
Country : US
Telephone Number : 915-549-2868
Fax Number : 915-833-3227
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 08/09/2011

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