COLLOM & CARNEY CLINIC ASSOCIATION NPI 1578545539

NPI Information

NPI: 1578545539
Provider Name: COLLOM & CARNEY CLINIC ASSOCIATION
Classification: Clinic/Center - 261QE0700X
Specialization: End-Stage Renal Disease (ESRD) Treatment
Entity Type: Organization
Doing Business As: NORTHEAST TEXAS DIALYSIS UNIT
CLIA Number: 45D2285828
Address: 606 LOOP 59
ATLANTA, TX
ZIP 75551
Phone: (903) 614-3601

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NPI Details

COLLOM & CARNEY CLINIC ASSOCIATION is an end-stage renal disease (esrd) treatment clinic center in Atlanta, TX. COLLOM & CARNEY CLINIC ASSOCIATION NPI is 1578545539. The provider is registered as an organization entity type.
The provider Is Doing Business As Northeast Texas Dialysis Unit.

The provider's business location address is:

606 LOOP 59
ATLANTA, TX
ZIP 75551-510
Phone: (903) 614-3601
Fax: (903) 792-0951

The provider's authorized official is Pat Roberts .
The authorized official title is Administrator and has the following contact phone number (903) 614-3601.

The CLIA number assigned to this NPI record is 45D2285828 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/16/2005 and was last updated on 3/23/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	000189	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	100702210C	MEDICAID	OKLAHOMA
2	087889401	MEDICAID	TEXAS
3	452710	MEDICARE OSCAR/CERTIFICATION
4	149926734	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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