MEDICARE: DR. ERIC STEPHEN HOLLABAUGH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ND0101X	MOHS-Micrographic Surgery Physician	H6293	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0700006740	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2E7355	OTHER	TX	PTAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497749824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC STEPHEN HOLLABAUGH M.D.

Provider Business Mailing Address
First Line	:	1030 S COIT RD
Second Line	:
City	:	PROSPER
State	:	TX
Zip	:	75078-2950
Country	:	US
Telephone Number	:	469-769-3376
Fax Number	:	972-378-0630

Provider Business Practice Location Address
First Line	:	5805 COIT RD STE 203
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-6990
Country	:	US
Telephone Number	:	469-769-3376
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	02/24/2025

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