# COLLOM & CARNEY CLINIC ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COLLOM & CARNEY CLINIC
- **Other names:** Collom and Carney Clinic Radiology
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1447232814
- **Legal business name:** COLLOM & CARNEY CLINIC
- **Authorized official:** MARY E DWIGHT CCS-P, MHA, CMPE (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (903) 614-3282

## Contact information

- **Practice address:** 5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
- **Practice address phone:** (903) 614-3000
- **Practice address fax:** (903) 614-3525
- **Mailing address:** 5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
- **Mailing address phone:** (903) 614-3000
- **Mailing address fax:** (903) 614-3525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | TX | Yes |

## Other

- **Enumeration date:** 11/18/2005
- **Last updated:** 01/24/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 082238901 | — | TX |
| 01 | — | CU0435 | RAILROAD MEDICARE | TX |