1881607307 NPI number — RICHARD A COLLIER LPC

Table of content: RICHARD A COLLIER LPC (NPI 1881607307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881607307 NPI number — RICHARD A COLLIER LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLLIER
Provider First Name:
RICHARD
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881607307
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5709 5TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KATY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77493-1917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-392-5666
Provider Business Mailing Address Fax Number:
281-465-9291

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5709 5TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KATY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77493-1917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-392-5666
Provider Business Practice Location Address Fax Number:
281-465-9291
Provider Enumeration Date:
08/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  15345 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 164601 . This is a "VALUE OPTIONS ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 148115 . This is a "COMPSYCH PROVIDER ID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 095954601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 206990 . This is a "MHN PROVIDER ID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5117LC . This is a "BCBS PROVIDER ID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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