Organization
COLLOM & CARNEY CLINIC ASSOCIATION
Active
Organization
COLLOM & CARNEY CLINIC ASSOCIATION
Active
Other names
Northeast Texas Dialysis Unit
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAT ROBERTS (ADMINISTRATOR)
(903) 614-3601
Entity
Organization
Contact information
Practice address
606 LOOP 59, ATLANTA, TX 75551-1510
(903) 614-3601
(903) 792-0951
Mailing address
4800 TEXAS BLVD, TEXARKANA, TX 75503-3033
(903) 614-3600
(903) 792-0951
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
000189
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087889401
—
TX
05
—
100702210C
—
OK
05
—
149926734
—
AR
Enumeration date
11/16/2005
Last updated
03/23/2010
Update your record
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