1427161595 NPI number — COLQUITT & ASSOCIATES RESOURCE GROUP, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427161595 NPI number — COLQUITT & ASSOCIATES RESOURCE GROUP, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLQUITT & ASSOCIATES RESOURCE GROUP, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1427161595
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 540817
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND PRAIRIE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75054-0817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-572-7500
Provider Business Mailing Address Fax Number:
972-572-7505

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7125 MARVIN D LOVE FWY
Provider Second Line Business Practice Location Address:
SUITE 201A
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75237-3175
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-572-7500
Provider Business Practice Location Address Fax Number:
972-572-7505
Provider Enumeration Date:
08/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COLQUITT
Authorized Official First Name:
EMMA
Authorized Official Middle Name:
ROSE
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
972-572-7500

Provider Taxonomy Codes

  • Taxonomy code: 246XS1301X , 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)





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