Provider Demographics
NPI:1407926660
Name:COLGIN, WILLIAM MADISON III (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MADISON
Last Name:COLGIN
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 SILVERADO TRL
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2841
Mailing Address - Country:US
Mailing Address - Phone:281-342-4995
Mailing Address - Fax:281-342-1857
Practice Address - Street 1:905 SILVERADO TRL
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2841
Practice Address - Country:US
Practice Address - Phone:281-342-4995
Practice Address - Fax:281-342-1857
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88312602Medicaid
TX600045Medicare ID - Type Unspecified