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General NPI Number Information
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NPI Number | 1336125384
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Entity Type | Individual
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Provider Name | JOHN ROBERT HOLT DDS
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Gender | Male
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 11/19/2013
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Provider Practice Location Address
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Address Line | 2309 YORK AVE
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City | LUBBOCK
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State | TX
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Zip | 79407-2286
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Country | US
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Telephone | 806-783-0520
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Fax | 806-783-0674
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Provider Business Mailing Address
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Address Line | 2309 YORK AVE
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City | LUBBOCK
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State | TX
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Zip | 79407-2286
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Country | US
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Telephone | 806-783-0520
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Fax | 806-783-0674
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 15567
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 15567
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License Number State | TX
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