Provider Demographics
NPI:1821386996
Name:KOLB, CLAIRE MACPHERSON (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:CLAIRE
Middle Name:MACPHERSON
Last Name:KOLB
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1264 TAMU
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77843-0001
Mailing Address - Country:US
Mailing Address - Phone:979-458-8300
Mailing Address - Fax:979-458-8319
Practice Address - Street 1:1264 TAMU
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77843-0001
Practice Address - Country:US
Practice Address - Phone:979-458-8300
Practice Address - Fax:979-458-8319
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTEMP LICENSE363A00000X
TXPA07372363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant