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Individual

MARTHA LYNN MCCOLLOUGH

Active
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Individual

MARTHA LYNN MCCOLLOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
J5401
TX
207ND0900X
Dermatopathology Physician
J5401
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
044554601
TX
01
070012699
RAILROAD MEDICARE PTAN
TX
01
85Z813
BLUE CROSS AND BLUE SHIELD PATHOLOGY
TX
01
8A2686
BLUE CROSS AND BLUE SHIELD CLINIC
TX
Enumeration date
06/27/2006
Last updated
05/22/2008
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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