Healthcare Provider Details

I. General information

NPI: 1144255704
Provider Name (Legal Business Name): JOSEF E. HOLME, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 W BEN WHITE BLVD
AUSTIN TX
78704-6888
US

IV. Provider business mailing address

PO BOX 684665
AUSTIN TX
78768-4665
US

V. Phone/Fax

Practice location:
  • Phone: 512-442-1996
  • Fax: 512-441-1093
Mailing address:
  • Phone: 512-442-1996
  • Fax: 512-441-1093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK2041
License Number StateTX

VIII. Authorized Official

Name: NANCY MOORE
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 512-342-0455