Provider Demographics
NPI:1932104536
Name:WELDON E COLLINS MD
Entity Type:Organization
Organization Name:WELDON E COLLINS MD
Other - Org Name:W. EDWARD COLLINS MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:T
Authorized Official - Last Name:DINEEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PHN
Authorized Official - Phone:409-835-1333
Mailing Address - Street 1:2929 CALDER ST
Mailing Address - Street 2:STE 312
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1831
Mailing Address - Country:US
Mailing Address - Phone:409-835-1333
Mailing Address - Fax:409-835-2629
Practice Address - Street 1:2929 CALDER ST
Practice Address - Street 2:STE 312
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1831
Practice Address - Country:US
Practice Address - Phone:409-835-1333
Practice Address - Fax:409-835-2629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9316174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00150081OtherRAILROAD MEDICARE PIN
TX114648201Medicaid
TX0700022935OtherRAILROAD MEDICARE PIN
TX610473Medicare PIN
TX114648201Medicaid
TXP00150081OtherRAILROAD MEDICARE PIN
TX0700022935OtherRAILROAD MEDICARE PIN