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Individual

DR. JOHNNY M COLLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 PINE ST, TEXARKANA, TX 75501
(703) 701-0156
(903) 793-7996
Mailing address
51 DOGWOOD LAKE DRIVE, TEXARKANA, TX 75503
(903) 701-0156
(903) 793-7996

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
F3854
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09743
TX
Enumeration date
07/15/2005
Last updated
10/25/2013
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