Healthcare Provider Details

I. General information

NPI: 1336720663
Provider Name (Legal Business Name): HOLLY HARPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 PHILOMENA ST
AUSTIN TX
78723-3210
US

IV. Provider business mailing address

1807 ROCKMOOR AVE
AUSTIN TX
78703-2028
US

V. Phone/Fax

Practice location:
  • Phone: 512-422-1014
  • Fax:
Mailing address:
  • Phone: 512-484-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV0416
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberV0416
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: