Healthcare Provider Details

I. General information

NPI: 1538775572
Provider Name (Legal Business Name): HOLLY HAMBACHER YORK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 W PARMER LN STE G
AUSTIN TX
78727-4657
US

IV. Provider business mailing address

7505 N LOOP 1604 E STE 101
LIVE OAK TX
78233-2604
US

V. Phone/Fax

Practice location:
  • Phone: 512-670-3238
  • Fax: 512-670-3241
Mailing address:
  • Phone: 210-590-4000
  • Fax: 210-590-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: