COLLOM AND CARNEY CLINIC ASSOCIATION (NPI# 1285616003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285616003 |
| Entity Type | Organization |
| Organization Name | COLLOM AND CARNEY CLINIC ASSOCIATION |
| Other Organization Name | COLLOM AND CARNEY CLINIC GASTROENTEROLOGY |
| Practice Address |
5002 Cowhorn Creek Rd Texarkana TX 75503 |
| Practice Telephone | 9036143000 |
| Practice Fax Number | 9036143525 |
| Mailing Telephone | 9036143000 |
| Mailing Fax Number | 9036143525 |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2019-10-01 |
| Authorized Official Name | MARY E DWIGHT (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 9036143282 |
| Authorized Official Credential | CCS-P, MHA, CMPE |
| Is Organization Subpart | Y |
| Parent Organization Name | COLLOM AND CARNEY CLINIC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
========= | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | RAILROAD MEDICARE | CU0435 | 01 |
| TX | 082237101 | 05 |
| Other Name | Type Code |
|---|---|
| Collom and Carney Clinic Gastroenterology | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407273287 | Collom and Carney Clinic Association | Neurological Surgery | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2014-03-18 |
| 1316364193 | Collom and Carney Clinic Association | Radiology | 511 W 11th St, Texarkana, TX 75501-4300 | 2014-03-18 |
| 1265414635 | Collom and Carney Clinic Association | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2005-11-18 |
| 1447232814 | Collom and Carney Clinic Association | Clinic/Center | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-11-18 |
| 1285616805 | Collom and Carney Clinic Association | Family Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2005-11-18 |
| 1376525832 | Collom and Carney Clinic Association | Otolaryngology | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-11-18 |
| 1619959244 | Collom and Carney Clinic Association | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2005-11-18 |
| 1952383770 | Collom and Carney Clinic Association | Physical Medicine & Rehabilitation | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2005-11-17 |
| 1588646301 | Collom and Carney Clinic Association | Pediatrics | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-11-17 |
| 1083696801 | Collom and Carney Clinic Association | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-11-17 |
| Street Address |
5002 COWHORN CREEK RD |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447255229 | Jeffrey David Decaprio | Surgery | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-06-17 |
| 1225681604 | Lauren N. Hadaway | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2019-07-24 |
| 1144872839 | Brandi M. Martin | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2019-07-12 |
| 1093292104 | Heidi R Smith | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-07-20 |
| 1194215814 | Angela L Bowen | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-05-17 |
| 1689174955 | Cody C Ray | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-02-13 |
| 1699282087 | Melissa Ann Lamon | Registered Nurse | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2018-01-07 |
| 1013443589 | Laura L Jackson | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-05-03 |
| 1316478852 | Schamma Salomon | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-03-26 |
| 1346781325 | Melissa Elizabeth Redfearn | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-03-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164771515 | Ranga Balasekaran Md Pa | Internal Medicine | 1002 Texas Blvd Ste 401, Texarkana, TX 75501-5113 | 2012-08-31 |
| 1841499100 | Brian Jin So | Internal Medicine | 1920 Moores Lane, Texarkana, TX 75503 | 2007-07-16 |
| 1396856555 | Robert Alfred Skinner | Internal Medicine | 1323 Hazel St, Texarkana, TX 75501-4434 | 2006-08-31 |
| 1154309375 | James Joseph Boehmke Jr. | Internal Medicine | 1920 Moores Ln Ste A, Texarkana, TX 75503-4660 | 2006-01-06 |
| 1548407034 | Ayotokunbo Olosunde | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2009-01-21 |
| 1639179500 | Michael Paolucci | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033716014 | Kingwood Gastroenterology Pllc | Internal Medicine | 210 W Park Ste 100, Livingston, TX 77351-8337 | 2020-10-03 |
| 1003432543 | Dc Gastro Konsult | Internal Medicine | 11620 Pellicano Dr Ste B, El Paso, TX 79936-6250 | 2020-06-21 |
| 1851946917 | Sunbal Zafar Pllc | Internal Medicine | 3125 Matlock Rd Ste 108, Arlington, TX 76015-2905 | 2019-08-06 |
| 1174188718 | Kesar Family Pllc | Internal Medicine | 3303 Rodgers Road, Suite 250, San Antonio, TX 78251 | 2019-05-09 |
| 1205393279 | Fatema S Uddin Md, Pllc | Internal Medicine | 601 Omega Dr Ste 201, Arlington, TX 76014-2075 | 2019-02-26 |
| 1952875932 | Aimee Lin Simington | Internal Medicine | 609 Medical Center Dr Ste 2600, Decatur, TX 76234-3846 | 2019-01-14 |
| 1265903652 | Michael S Brown | Internal Medicine | 5323 Harry Hines Blvd Rm L5.238, Dallas, TX 75390-9046 | 2018-12-10 |
| 1174098883 | Texas Digestive Care, Pllc | Internal Medicine | 2900 N I 35 Ste 210, Denton, TX 76201-5145 | 2018-10-09 |
| 1194208892 | El Paso Center for Pediatric Gastroenterology Pa | Internal Medicine | 2311 N Mesa St Ste C, El Paso, TX 79902-3575 | 2018-09-10 |
| 1821594052 | Tanmayi Gaikwad | Internal Medicine | 16651 Southwest Fwy Ste 370, Sugar Land, TX 77479-2348 | 2018-04-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.