Individual
MR. HENRY LEE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
2713 CLOVERMEADOW DR, FORT WORTH, TX 76123-2107
(817) 346-9151
(817) 346-9151
Mailing address
PO BOX 1733, FORT WORTH, TX 76101-1733
(817) 455-1680
(817) 346-9151
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
02164
TX
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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