Basic Information
| Provider Information | |||||||||
| NPI: | 1073804688 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLLIER | ||||||||
| FirstName: | CRAIG | ||||||||
| MiddleName: | WALTER | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | CRT, RCP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9351 ASPEN OAK | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782545313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105630137 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7400 MERTON MINTER ST | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782294404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106175300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2011 | ||||||||
| LastUpdateDate: | 04/29/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 227800000X | 61620 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified |
No ID Information.