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General NPI Number Information
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NPI Number | 1518465079
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Entity Type | Organization
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Legal Business Name | HOLLY PSYCHIATRIC CLINIC PLLC
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Dates
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Enumeration Date | 01/30/2018
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 5151 FLYNN PKWY STE 307
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-4384
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Country | US
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Telephone | 361-993-4835
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Fax | 361-993-7043
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Provider Business Mailing Address
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Address Line | 5151 FLYNN PKWY STE 307
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-4384
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Country | US
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Telephone | 361-993-4835
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Fax | 361-993-7043
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LAARNIE VINDUA
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Credential |
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Telephone | 972-900-3605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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