COLLOM & CARNEY WESTSIDE CLINIC
NPI 1720060494
Durable Medical Equipment & Medical Supplies in Wake Village, TX

Q: What is Collom & Carney Clinic's NPI number?

The NPI number for Collom & Carney Clinic is 1720060494. It was assigned to this organization in the NPPES registry on November 17, 2005. The provider is also known as Collom & Carney Westside Clinic.

Q: What is Collom & Carney Clinic's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Active since November 17, 2005CLIA 45D0482327 · Waiver

815 N KINGS HWY, WAKE VILLAGE, TX 75501(903) 614-3937(903) 832-7163 Get Directions Write a Review

NPPES record last updated: February 24, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 24, 2023, Oct 2, 2019 (2 updates tracked since 2019).

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About Collom & Carney Westside Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COLLOM & CARNEY WESTSIDE CLINIC (NPI 1720060494) is a healthcare organization registered as a durable medical equipment & medical supplies in Wake Village, Texas and active in the NPI registry since November 2005. The organization holds a CLIA Waiver certificate valid through December 29, 2027 and lists Mary E Dwight, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1720060494

Entity TypeOrganization

Primary Taxonomy332B00000X

Legal Business NameCOLLOM & CARNEY CLINIC

Location Address815 N KINGS HWYWake Village, TX 75501-5700

Mailing Address5002 Cowhorn Creek RdTexarkana, TX 75503-9766 · (903) 614-3000 · Fax (903) 614-3525

Phone(903) 614-3937

Fax(903) 832-7163

Organization SubpartYes

Authorized OfficialMary E DwightChief Operating Officer · (903) 614-3282

Enumeration DateNovember 17, 2005

Last NPPES UpdateFebruary 24, 20232 updates tracked since enumeration

NPPES CertifiedFebruary 24, 2023

✔ NPI 1720060494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers

Taxonomy Code332B00000X

Definition

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

815 N KINGS HWY, Wake Village, TX 75501

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Other Names 1

Other NameCollom & Carney Westside Clinic

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D0482327

Collom & Carney Westside Clinic · Texarkana, TX

Active · expires Dec 29, 2027

CLIA Number45D0482327

Laboratory TypePhysician Office

Certificate Effective DateDecember 30, 2025

Certificate Expiration DateDecember 29, 2027

Laboratory DirectorCarla Rose Mt Ascp

Laboratory Phone(903) 614-3711

Laboratory LocationCollom & Carney Westside Clinic815 North Kings Highway, Texarkana, TX 75501

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RICHARD L TYLER MD

Family Medicine