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General NPI Number Information
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NPI Number | 1629359849
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Entity Type | Organization
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Legal Business Name | HOLLAND MEDICAL GROUP, PA
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 01/25/2012
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Provider Practice Location Address
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Address Line | 1313 HOLLAND ST SUITE C
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City | HOUSTON
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State | TX
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Zip | 77029-2890
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Country | US
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Telephone | 713-637-7000
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Fax | 713-637-7010
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Provider Business Mailing Address
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Address Line | 1313 HOLLAND ST SUITE C
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City | HOUSTON
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State | TX
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Zip | 77029-2890
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Country | US
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Telephone | 713-637-7000
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Fax | 713-637-7010
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONNIE EVANS
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Credential | MD
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Telephone | 281-451-4654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | H5705
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | H5705
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | H5705
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License Number State | TX
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