Provider Demographics
NPI:1730154667
Name:COLLINS, CLEVE BRANTLEY (MD)
Entity type:Individual
Prefix:DR
First Name:CLEVE
Middle Name:BRANTLEY
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16620 N US HIGHWAY 281
Mailing Address - Street 2:STE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2327
Mailing Address - Country:US
Mailing Address - Phone:210-614-1231
Mailing Address - Fax:210-616-0704
Practice Address - Street 1:5131 MEDICAL DR
Practice Address - Street 2:STE 120
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5062
Practice Address - Country:US
Practice Address - Phone:210-614-1515
Practice Address - Fax:210-615-6904
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2012-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXF2608207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115030203Medicaid
TX115030203Medicaid
TX82A555Medicare ID - Type Unspecified