Doctor Name: | MRS. LETHA H COLQUITT |
NPI Number: | 1023005725 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 541559 |
Business Practice Address: | 4701 W 7th St Texarkana, TX - 755016255 |
Business Phone Number: | 9038316848 |
Business Fax Number: | 9032237089 |
Mailing Address: | 2602 Saint Michael Dr, Ste 401 TEXARKANA |
State: | TX |
Postal Code: | 755032372 |
Phone Number: | 9036145390 |
Fax Number: | 9032237089 |
NPI Enumeration Date: | 09/29/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 541559 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |