Healthcare Provider Details

I. General information

NPI: 1639692882
Provider Name (Legal Business Name): MOLLY HOLODY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 TOWN CENTRE DR STE 130
ROUND ROCK TX
78664-7464
US

IV. Provider business mailing address

6700 WASHINGTON AVE S
EDEN PRAIRIE MN
55344-3405
US

V. Phone/Fax

Practice location:
  • Phone: 512-238-8006
  • Fax:
Mailing address:
  • Phone: 612-351-1529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number80763
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: