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General NPI Number Information
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NPI Number | 1497749824
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Entity Type | Individual
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Provider Name | ERIC STEPHEN HOLLABAUGH M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2005
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 5805 COIT RD STE 203
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City | PLANO
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State | TX
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Zip | 75093-6990
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Country | US
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Telephone | 469-769-3376
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 S COIT RD
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City | PROSPER
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State | TX
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Zip | 75078-2950
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Country | US
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Telephone | 469-769-3376
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Fax | 972-378-0630
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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 | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | H6293
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License Number State | TX
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