Provider Demographics
NPI:1396138210
Name:COLLIER, CARLA (AGPCNP)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3706 TEMPLE DR
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-2912
Mailing Address - Country:US
Mailing Address - Phone:512-947-2063
Mailing Address - Fax:
Practice Address - Street 1:2813 SMITH RANCH RD
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5254
Practice Address - Country:US
Practice Address - Phone:713-436-8166
Practice Address - Fax:713-436-8168
Is Sole Proprietor?:No
Enumeration Date:2015-03-17
Last Update Date:2015-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127718363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology