MEDICARE: DR. KERRY D HOLLIMAN 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	207VM0101X	Maternal & Fetal Medicine Physician	S9517	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

General Provider Information

NPI Number	:	1528080892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERRY D HOLLIMAN M.D.

Provider Business Mailing Address
First Line	:	12200 RENFERT WAY STE G-3
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-5654
Country	:	US
Telephone Number	:	512-821-2540
Fax Number	:	127-761-9565

Provider Business Practice Location Address
First Line	:	12200 RENFERT WAY STE G-3
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-5654
Country	:	US
Telephone Number	:	512-821-2540
Fax Number	:	512-776-1956

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	02/10/2022

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