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General NPI Number Information
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NPI Number | 1083650311
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Entity Type | Individual
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Provider Name | GARY WAYNE HOLMAN CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7900 FANNIN ST SUITE 2300
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City | HOUSTON
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State | TX
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Zip | 77054-2934
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Country | US
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Telephone | 713-790-1349
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Fax | 713-790-0028
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Provider Business Mailing Address
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Address Line | 1719 OAK BROOK LANE
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City | ALLEN
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State | TX
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Zip | 75002-1803
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Country | US
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Telephone | 972-429-8638
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 437923
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License Number State | TX
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