Provider Demographics
NPI:1326162389
Name:COLBY, ALAN BRENT (DO)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:BRENT
Last Name:COLBY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:720 W 34TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1205
Mailing Address - Country:US
Mailing Address - Phone:512-454-7741
Mailing Address - Fax:512-451-7245
Practice Address - Street 1:720 W 34TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1205
Practice Address - Country:US
Practice Address - Phone:512-454-7741
Practice Address - Fax:512-451-7245
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ40502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG25084Medicare UPIN