Provider Demographics
NPI:1700192598
Name:COLIP, DELL, AND ASSOCIATES, A PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:COLIP, DELL, AND ASSOCIATES, A PROFESSIONAL ASSOCIATION
Other - Org Name:CHARLES R DELL MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:DELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-262-1596
Mailing Address - Street 1:401 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-5638
Mailing Address - Country:US
Mailing Address - Phone:972-262-1596
Mailing Address - Fax:972-642-2294
Practice Address - Street 1:401 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5638
Practice Address - Country:US
Practice Address - Phone:972-262-1596
Practice Address - Fax:972-642-2294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2010-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4293207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty