Provider Demographics
NPI:1427161595
Name:COLQUITT & ASSOCIATES RESOURCE GROUP, INC.
Entity type:Organization
Organization Name:COLQUITT & ASSOCIATES RESOURCE GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:COLQUITT
Authorized Official - Suffix:
Authorized Official - Credentials:RDCS, MBA
Authorized Official - Phone:972-572-7500
Mailing Address - Street 1:PO BOX 540817
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-0817
Mailing Address - Country:US
Mailing Address - Phone:972-572-7500
Mailing Address - Fax:972-572-7505
Practice Address - Street 1:7125 MARVIN D LOVE FWY
Practice Address - Street 2:SUITE 201A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3175
Practice Address - Country:US
Practice Address - Phone:972-572-7500
Practice Address - Fax:972-572-7505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTCV13Medicare ID - Type UnspecifiedIDTF