Healthcare Provider Details

I. General information

NPI: 1518814599
Provider Name (Legal Business Name): SEAN CHRISTOPHER HOLMES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19010 PRIEST BLVD.
LYTLE TX
78052
US

IV. Provider business mailing address

310 W OAKLAWN RD
PLEASANTON TX
78064-4033
US

V. Phone/Fax

Practice location:
  • Phone: 830-772-9865
  • Fax: 830-772-9821
Mailing address:
  • Phone: 830-569-8940
  • Fax: 830-224-6905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number845279
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1228266
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1228266
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: