Provider Demographics
NPI:1376271163
Name:COLVIN, DEVON MATTHEW
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:MATTHEW
Last Name:COLVIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 N BRAESWOOD BLVD APT 301
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-2864
Mailing Address - Country:US
Mailing Address - Phone:214-901-0913
Mailing Address - Fax:
Practice Address - Street 1:12301 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-6207
Practice Address - Country:US
Practice Address - Phone:713-275-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor