Individual
MR. CHAD COLLOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, MSN, PMHNP-BC
Contact information
Practice address
2206 MARILLA, DALLAS, TX 75201
(214) 566-8727
Mailing address
2206 MARILLA DRIVE, DALLAS, TX 75201-5906
(214) 566-8727
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
675826
TX
Other
Enumeration date
06/23/2008
Last updated
04/22/2009
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