Provider Demographics
NPI:1184133993
Name:COLLINS, MARY T (NURSE AIDE,)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:T
Last Name:COLLINS
Suffix:
Gender:F
Credentials:NURSE AIDE,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 671103
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77267-1103
Mailing Address - Country:US
Mailing Address - Phone:713-979-8771
Mailing Address - Fax:
Practice Address - Street 1:7313 NORTHLINE DR APT 711
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-1550
Practice Address - Country:US
Practice Address - Phone:713-979-8771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-25
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide