Provider Demographics
NPI:1275533846
Name:COLQUITT, CATHERINE A (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:A
Last Name:COLQUITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 8TH AVENUE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4141
Mailing Address - Country:US
Mailing Address - Phone:817-921-0123
Mailing Address - Fax:817-924-1717
Practice Address - Street 1:1307 8TH AVENUE
Practice Address - Street 2:SUITE 306
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4141
Practice Address - Country:US
Practice Address - Phone:817-921-0123
Practice Address - Fax:817-924-1717
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1365207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J33TOtherGROUP MEDICARE NUMBER
TX0831497-03OtherGROUP MEDICAID NUMBER - TPI
TX1282196-06Medicaid
TX128219604Medicaid
TX00J32TOtherGROUP MEDICARE NUMBER
TXPH0004OtherGROUP MEDICARE NUMBER
TX128219607OtherMEDICAID TPI
TX1282196-06Medicaid
TX8K8902Medicare PIN
TX83Z334Medicare PIN
TXPH0004OtherGROUP MEDICARE NUMBER