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General NPI Number Information
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NPI Number | 1053823344
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Entity Type | Organization
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Legal Business Name | HOLIDAY'S FAMILY MEDICAL CLINIC
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Dates
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Enumeration Date | 10/26/2017
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Last Update Date | 06/13/2024
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Provider Practice Location Address
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Address Line | 16300 KUYKENDAHL RD STE 410
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City | HOUSTON
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State | TX
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Zip | 77068-2751
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Country | US
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Telephone | 832-286-4459
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Fax | 832-286-4361
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Provider Business Mailing Address
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Address Line | 16300 KUYKENDAHL RD STE 410
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City | HOUSTON
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State | TX
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Zip | 77068-2751
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Country | US
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Telephone | 832-286-4459
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Fax | 832-286-4361
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Authorized Official
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Title or Position | OWNER
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Name | LISA H HARMON
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Credential | FNP
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Telephone | 832-286-4459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP130367
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License Number State | TX
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