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General NPI Number Information
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NPI Number | 1609970003
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Entity Type | Organization
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Legal Business Name | EDWARD LEE HOLT, DO, P.A.
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 1795 N HIGHWAY 77 STE 103
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City | WAXAHACHIE
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State | TX
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Zip | 75165-7876
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Country | US
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Telephone | 972-937-1588
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Fax | 972-937-1274
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Provider Business Mailing Address
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Address Line | 1795 N HIGHWAY 77 STE 103
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City | WAXAHACHIE
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State | TX
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Zip | 75165-7876
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Country | US
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Telephone | 972-937-1588
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Fax | 972-937-1274
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Authorized Official
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Title or Position | PHYSICIAN
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Name | EDWARD LEE HOLT
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Credential | DO
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Telephone | 972-937-1588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | L8248
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License Number State | TX
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