Individual
PHILLIP C COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 E 15TH ST, PATHOLOGY DEPARTMENT, AUSTIN, TX 78701-1930
(512) 324-7516
Mailing address
PO BOX 164106, AUSTIN, TX 78716-4106
(512) 324-7516
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
E8401
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124422002
—
TX
05
—
124422003
—
TX
05
—
124422005
—
TX
05
—
124422006
—
TX
01
—
80P641
BCBS OF TX
—
Enumeration date
11/07/2005
Last updated
03/27/2009
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