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General NPI Number Information
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NPI Number | 1205050234
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Entity Type | Organization
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Legal Business Name | RICHARD G HOLLAND
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3711 20TH SUITE C
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City | LUBBOCK
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State | TX
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Zip | 79410-1223
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Country | US
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Telephone | 806-797-4327
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Fax | 806-797-2680
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Provider Business Mailing Address
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Address Line | 3711 20TH SUITE C
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City | LUBBOCK
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State | TX
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Zip | 79410-1223
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Country | US
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Telephone | 806-797-4327
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Fax | 806-797-2680
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD GREGORY HOLLAND
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Credential |
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Telephone | 806-797-4327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 50083
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License Number State | TX
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