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Organization

COLLOM & CARNEY CLINIC ASSOCIATION

Active
Parent organization
COLLOM & CARNEY CLINIC
Other names
Collom and Carney Clinic Radiology
Organization subpart
Yes

Provider details

NPI number
Legal business name
COLLOM & 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
261QR0200X
Radiology Clinic/Center
Primary
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
082238901
TX
01
CU0435
RAILROAD MEDICARE
TX
Enumeration date
11/18/2005
Last updated
01/24/2023
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