Organization
COLLOM AND CARNEY CLINIC ASSOCIATION
Active
Parent organization
COLLOM AND CARNEY CLINIC
Other names
Collom and Carney Clinic General Surgery & ENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLLOM AND CARNEY CLINIC
Authorized official
MARY E DWIGHT CCS-P, MHA, CMPE (CHIEF OPERATING OFFICER)
(903) 614-3282
Entity
Organization
Contact information
Practice address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Mailing address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
TX
208600000X
Surgery Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082235501
—
TX
01
—
CU0435
RAILROAD MEDICARE
—
Enumeration date
11/18/2005
Last updated
02/24/2023
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