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NPI Code Detail

MEDICARE: DR. NNYEKAA COLLINS M.D.

MEDICARE: DR. NNYEKAA COLLINS M.D.
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
1207Q00000XFamily Medicine PhysicianP8231TX
2207QG0300XGeriatric Medicine (Family Medicine) PhysicianP8231TX

General Provider Information

NPI Number : 1639499858
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NNYEKAA COLLINS M.D.
Provider Business Mailing Address
First Line : 1500 S MAIN ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4917
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1500 S MAIN ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4917
Country : US
Telephone Number : 817-921-3431
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2010
Last Update Date : 03/17/2026

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