MEDICARE: MR. MICHAEL IAN COLLINGS PA-C

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	363AS0400X	Surgical Physician Assistant	PA18763	TX
2	363A00000X	Physician Assistant	PA18763	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA18763	OTHER	TX	TEXAS MEDICAL BOARD

General Provider Information

NPI Number	:	1740003227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL IAN COLLINGS PA-C

Provider Business Mailing Address
First Line	:	6803 BROOKPORT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-3019
Country	:	US
Telephone Number	:	210-274-5067
Fax Number	:

Provider Business Practice Location Address
First Line	:	7703 FLOYD CURL DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3901
Country	:	US
Telephone Number	:	210-450-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	06/02/2026

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