# COLLOM & CARNEY CLINIC ASSOCIATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1700868528
- **Legal business name:** COLLOM & CARNEY CLINIC ASSOCIATION
- **Authorized official:** DANA ROBYN MORTON (DIRECTOR CONTRACTING CREDENTIALING)
- **Authorized official phone:** (903) 614-3283

## Contact information

- **Practice address:** 1902 MOORES LN, TEXARKANA, TX 75503-4610
- **Practice address phone:** (903) 792-7515
- **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 |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/17/2005
- **Last updated:** 12/19/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 082240501 | — | TX |
| 01 | — | CU0435 | RAILROAD MEDICARE | — |