Organization
COLLOM AND CARNEY CLINIC ASSOCIATION
Active
Parent organization
COLLOM AND CARNEY CLINIC
Other names
Collom and Carney Clinic Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLLOM AND 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
208000000X
Pediatrics Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082230601
—
TX
01
—
CU0435
RAILROAD MEDICARE
—
Enumeration date
11/17/2005
Last updated
02/24/2023
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