Healthcare Provider Details

I. General information

NPI: 1538683024
Provider Name (Legal Business Name): JAMES HOLLON FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 S MAIN ST
GORDON TX
76453-1114
US

IV. Provider business mailing address

PO BOX 306
GORDON TX
76453-0306
US

V. Phone/Fax

Practice location:
  • Phone: 254-693-5211
  • Fax: 254-693-5774
Mailing address:
  • Phone: 254-693-5211
  • Fax: 254-693-5774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP134589
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: