Provider Demographics
NPI:1841391554
Name:COLLARD, QUENTIN L (MD)
Entity Type:Individual
Prefix:
First Name:QUENTIN
Middle Name:L
Last Name:COLLARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6534 RUTGERS AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-3851
Mailing Address - Country:US
Mailing Address - Phone:713-795-9500
Mailing Address - Fax:
Practice Address - Street 1:7400 FANNIN ST
Practice Address - Street 2:SUITE 900
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1920
Practice Address - Country:US
Practice Address - Phone:713-795-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9197208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
F47067Medicare UPIN