Individual
TIMOTHY KELLY COLGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
755 N 11TH ST STE P2280, BEAUMONT, TX 77702-1525
(409) 236-4900
(409) 236-4901
Mailing address
PO BOX 4356 DEPT 2234, HOUSTON, TX 77210-4356
(409) 236-4900
(409) 236-4901
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
G2674
TX
207RC0000X
Cardiovascular Disease Physician
MD2016-0640
NM
207RI0011X
Interventional Cardiology Physician
Primary
G2674
TX
207RI0011X
Interventional Cardiology Physician
MD2016-0640
NM
207UN0901X
Nuclear Cardiology Physician
G2674
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080142501
—
TX
05
—
115955005
—
TX
Enumeration date
07/07/2005
Last updated
01/25/2024
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