Provider Demographics
NPI:1992250427
Name:MICHAEL WADE COLLINS PT INC
Entity type:Organization
Organization Name:MICHAEL WADE COLLINS PT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:318-680-5500
Mailing Address - Street 1:1250 STATE ST
Mailing Address - Street 2:APT 3302
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2033
Mailing Address - Country:US
Mailing Address - Phone:318-680-5500
Mailing Address - Fax:501-325-2577
Practice Address - Street 1:1250 STATE ST
Practice Address - Street 2:APT 3302
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-2033
Practice Address - Country:US
Practice Address - Phone:318-680-5500
Practice Address - Fax:501-325-2577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT27502251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, ClinicalGroup - Single Specialty