Provider Demographics
NPI:1154063105
Name:COLLINS PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:COLLINS PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:II
Authorized Official - Credentials:MSPT, LMT
Authorized Official - Phone:325-518-7066
Mailing Address - Street 1:1333 CLARKS DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-3144
Mailing Address - Country:US
Mailing Address - Phone:325-518-7066
Mailing Address - Fax:833-525-1931
Practice Address - Street 1:1290 S WILLIS ST STE 213
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-4048
Practice Address - Country:US
Practice Address - Phone:325-518-7066
Practice Address - Fax:833-525-1931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty