Healthcare Provider Details

I. General information

NPI: 1396785838
Provider Name (Legal Business Name): GERRY P HOLLAND DO PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 09/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SOUTH MCGEE SUITE 101
BORGER TX
79007
US

IV. Provider business mailing address

100 SOUTH MCGEE SUITE 101
BORGER TX
79007
US

V. Phone/Fax

Practice location:
  • Phone: 806-274-5131
  • Fax: 806-274-5132
Mailing address:
  • Phone: 806-274-5131
  • Fax: 806-274-5132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GERRY P HOLLAND
Title or Position: PHYSICIAN
Credential: DO
Phone: 806-274-5131