MEDICARE: IRA NEIL HOLLANDER MD

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	208800000X	Urology Physician	E8564	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508852021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRA NEIL HOLLANDER MD

Provider Business Mailing Address
First Line	:	1701 RIVER RUN
Second Line	:	SUITE 902
City	:	FORT WORTH
State	:	TX
Zip	:	76107-6579
Country	:	US
Telephone Number	:	817-332-8847
Fax Number	:	817-332-3614

Provider Business Practice Location Address
First Line	:	1701 RIVER RUN
Second Line	:	SUITE 902
City	:	FORT WORTH
State	:	TX
Zip	:	76107-6579
Country	:	US
Telephone Number	:	817-332-8847
Fax Number	:	817-332-3614

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/13/2015

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Directions to “ IRA NEIL HOLLANDER MD” Practice Location

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