MEDICARE: DR. DAVID W HOLMES AUD, PHD

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	231HA2400X	Assistive Technology Practitioner Audiologist	50468	TX
2	231HA2500X	Assistive Technology Supplier Audiologist	50468	TX
3	231H00000X	Audiologist	50468	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	:	1952382624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID W HOLMES AUD, PHD

Provider Business Mailing Address
First Line	:	2083 RANA PARK
Second Line	:
City	:	FLINT
State	:	TX
Zip	:	75762-8824
Country	:	US
Telephone Number	:	817-201-6791
Fax Number	:

Provider Business Practice Location Address
First Line	:	2083 RANA PARK
Second Line	:
City	:	FLINT
State	:	TX
Zip	:	75762-8824
Country	:	US
Telephone Number	:	817-201-6791
Fax Number	:

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	07/21/2021

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