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General NPI Number Information
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NPI Number | 1457989238
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Entity Type | Individual
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Provider Name | JONATHAN LYLE HOLT MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2020
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 3500 HILLCREST DR STE 1
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City | WACO
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State | TX
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Zip | 76708-3144
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Country | US
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Telephone | 254-741-6641
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Fax | 254-537-4693
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Provider Business Mailing Address
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Address Line | 101 W LOUIS HENNA BLVD STE 300
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City | AUSTIN
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State | TX
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Zip | 78728-1203
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Country | US
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Telephone | 512-244-4272
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Fax | 512-593-4444
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 25674
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | V8284
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License Number State | TX
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