Organization
COLLOM & CARNEY CLINIC ASSOCIATION
Active
Parent organization
COLLOM AND CARNEY CLINIC
Other names
Collom & Carney Clinic, Collom and Carney Clinic Internal Medicine
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
(903) 614-3000
(903) 614-3525
Mailing address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503
(903) 614-3000
(903) 614-3525
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082234801
—
TX
05
—
107491002
—
AR
01
—
CU0435
RAILROAD MEDICARE
—
Enumeration date
11/18/2005
Last updated
08/05/2024
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