Organization
ANESTHESIA AND INTENSIVE CARE
Active
Other names
Anesthesia & Intensive Care Of
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY M COLLEY MD (ANESTHESIOLOGIST)
(903) 701-0156
Entity
Organization
Contact information
Practice address
1000 PINE STREET, TEXARKANA, TX 75501-5100
(903) 701-0156
(903) 793-7996
Mailing address
51 DOGWOOD LAKE DRIVE, TEXARKANA, TX 75503
(903) 701-0156
(903) 793-7996
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090112602
—
TX
05
—
111373002
—
AR
Enumeration date
01/30/2007
Last updated
10/25/2013
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