Provider Demographics
NPI:1275721177
Name:COLLIER, TEATA (RN)
Entity Type:Individual
Prefix:MS
First Name:TEATA
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 SPYGLASS RD
Mailing Address - Street 2:
Mailing Address - City:MC QUEENEY
Mailing Address - State:TX
Mailing Address - Zip Code:78123-3441
Mailing Address - Country:US
Mailing Address - Phone:830-221-0115
Mailing Address - Fax:
Practice Address - Street 1:243 SPYGLASS RD
Practice Address - Street 2:
Practice Address - City:MC QUEENEY
Practice Address - State:TX
Practice Address - Zip Code:78123-3441
Practice Address - Country:US
Practice Address - Phone:830-221-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX604082171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator