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General NPI Number Information
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NPI Number | 1255437414
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Entity Type | Organization
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Legal Business Name | HOLLAND HEALTH AND FAMILY CENTER
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 503 CROCKETT
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City | HOLLAND
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State | TX
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Zip | 76534
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Country | US
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Telephone | 254-657-2839
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Fax | 254-657-2845
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Provider Business Mailing Address
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Address Line | 204 HACKBERRY RD
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City | HOLLAND
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State | TX
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Zip | 76534
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Country | US
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Telephone | 254-657-2839
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Fax | 254-657-2845
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. JEREMY GIBSON
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Credential | MD
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Telephone | 254-657-2839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | K9540
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License Number State | TX
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