MEDICARE: MS. HOLLY LYN HOWELL

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	2255A2300X	Athletic Trainer	AT2862	TX

General Provider Information

NPI Number	:	1598730228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HOLLY LYN HOWELL

Provider Business Mailing Address
First Line	:	300 HOLLY PARK DR
Second Line	:	APT. 2059
City	:	ARLINGTON
State	:	TX
Zip	:	76014-4507
Country	:	US
Telephone Number	:	817-466-1284
Fax Number	:

Provider Business Practice Location Address
First Line	:	7001 SILO RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-3421
Country	:	US
Telephone Number	:	817-375-6829
Fax Number	:

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

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	07/08/2007

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