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General NPI Number Information
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NPI Number | 1528384401
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Entity Type | Organization
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Legal Business Name | PETER WILSON HOLLIMON M.D. PA
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 10/07/2010
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Provider Practice Location Address
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Address Line | 8534 VILLAGE DR SUITE E
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5501
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Country | US
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Telephone | 210-654-4583
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Fax | 210-654-8332
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Provider Business Mailing Address
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Address Line | 8534 VILLAGE DR SUITE E
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5501
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Country | US
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Telephone | 210-654-4583
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Fax | 210-654-8332
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Authorized Official
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Title or Position | M.D.
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Name | DR. PETER WILSON HOLLIMON
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Credential | M.D.
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Telephone | 210-654-4583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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