Healthcare Provider Details

I. General information

NPI: 1790945152
Provider Name (Legal Business Name): HOLLY MARIE FILER LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3456 N HILLS DR APT. #255
AUSTIN TX
78731-3202
US

IV. Provider business mailing address

3456 N HILLS DR APT. #255
AUSTIN TX
78731-3202
US

V. Phone/Fax

Practice location:
  • Phone: 512-771-3415
  • Fax:
Mailing address:
  • Phone: 512-771-3415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number205326
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: