Provider Demographics
NPI:1548571581
Name:COLIN, VINCENT MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:MICHAEL
Last Name:COLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 CLEAR CREEK RD STE 204
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4119
Mailing Address - Country:US
Mailing Address - Phone:254-519-3338
Mailing Address - Fax:254-519-2019
Practice Address - Street 1:2301 CLEAR CREEK RD STE 204
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4119
Practice Address - Country:US
Practice Address - Phone:254-519-3338
Practice Address - Fax:254-519-2019
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR8714207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX390008601Medicaid
TX713124OtherMEDICARE