Organization
COLLOM & CARNEY CLINIC ASSOCIATION
Active
Other names
Texarkana Regional Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAT ROBERTS (ADMINISTRATOR)
(903) 614-3601
Entity
Organization
Contact information
Practice address
4800 TEXAS BLVD, TEXARKANA, TX 75503-3033
(903) 614-3600
(903) 792-0951
Mailing address
4800 TEXAS BLVD, TEXARKANA, TX 75503-3033
(903) 614-3600
(903) 792-0951
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
000190
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087806801
—
TX
05
—
100702210B
—
OK
05
—
107721134
—
AR
Enumeration date
11/16/2005
Last updated
03/23/2010
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