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Individual

JAMES LANE COLLIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 531-4500
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
577239
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1158352805
TX
05
154340701
AR
05
158352802
TX
05
158352803
TX
01
75-1976930-005
TRICARE
TX
01
82711
BLUE CROSS
AR
01
8307UB
BCBS
TX
01
8339UE
BCBS
TX
01
83899U
BLUE CROSS
TX
01
P00933609
RAILROAD
TX
01
TIN PLUS 015
TRICARE
TX
Enumeration date
07/11/2005
Last updated
10/14/2014
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