Provider Demographics
NPI:1417282179
Name:COLLINS, JAMES T (PT)
Entity Type:Individual
Prefix:PROF
First Name:JAMES
Middle Name:T
Last Name:COLLINS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 PEASE RD #6
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-4806
Mailing Address - Country:US
Mailing Address - Phone:512-294-1326
Mailing Address - Fax:
Practice Address - Street 1:3508 FAR WEST BLVD STE 240
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-2281
Practice Address - Country:US
Practice Address - Phone:512-832-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11822302251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic