Provider Demographics
NPI:1598296246
Name:COLLETT, GEOFFREY (MD)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:
Last Name:COLLETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GEOFFREY
Other - Middle Name:
Other - Last Name:COLLETT FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4747 BELLAIRE BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4527
Mailing Address - Country:US
Mailing Address - Phone:281-800-1585
Mailing Address - Fax:281-203-0024
Practice Address - Street 1:4747 BELLAIRE BLVD STE 130
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4527
Practice Address - Country:US
Practice Address - Phone:281-800-1585
Practice Address - Fax:281-203-0024
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT1041207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA271334OtherBOARD OF REGISTRATION IN MEDICINE