Provider Demographics
NPI:1417157124
Name:DIANA COLLINS MD PA
Entity Type:Organization
Organization Name:DIANA COLLINS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:280-240-7477
Mailing Address - Street 1:1 SUGAR CREEK CENTER BLVD
Mailing Address - Street 2:SUITE 955
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3558
Mailing Address - Country:US
Mailing Address - Phone:281-240-7477
Mailing Address - Fax:281-240-7508
Practice Address - Street 1:1 SUGAR CREEK CENTER BLVD
Practice Address - Street 2:SUITE 955
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3558
Practice Address - Country:US
Practice Address - Phone:281-240-7477
Practice Address - Fax:281-240-7508
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIANA COLLINS MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ45342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
872707OtherUPIN