Provider Demographics
NPI:1457804593
Name:COLLINS FAMILY PLANNING CLINIC
Entity type:Organization
Organization Name:COLLINS FAMILY PLANNING CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, WHNP-BC
Authorized Official - Phone:817-922-8182
Mailing Address - Street 1:1100 BRIDGEWOOD DR STE 120
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-0809
Mailing Address - Country:US
Mailing Address - Phone:817-922-8182
Mailing Address - Fax:866-638-4872
Practice Address - Street 1:1100 BRIDGEWOOD DR STE 120
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-0809
Practice Address - Country:US
Practice Address - Phone:817-922-8182
Practice Address - Fax:866-638-4872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX444821261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility