Basic Information
| Provider Information | |||||||||
| NPI: | 1376956466 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLLINS | ||||||||
| FirstName: | ALISON | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 847522 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752847522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9035315000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2026 S JACKSON ST | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 757665822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9035865678 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2014 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0102204318 | VA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 5101022945 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | R1723 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 587738YS6V | 01 | TX | MEDICARE | OTHER | P01878597 | 01 | TX | MEDICARE RAIL ROAD | OTHER | 75-1976930-005 | 01 | TX | TRICARE | OTHER | 374239701 | 05 | TX | MEDICAID | 8GY131 | 01 | TX | BCBS | OTHER |