Provider Demographics
NPI:1609198423
Name:COLLINS, HERBERT
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:
Last Name:COLLINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6430 FM 1960 RD W
Mailing Address - Street 2:142
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-3902
Mailing Address - Country:US
Mailing Address - Phone:281-537-6636
Mailing Address - Fax:
Practice Address - Street 1:6430 FM 1960 RD W
Practice Address - Street 2:142
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-3902
Practice Address - Country:US
Practice Address - Phone:281-537-6636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-21
Last Update Date:2010-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide