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General NPI Number Information
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NPI Number | 1669961918
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Entity Type | Individual
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Provider Name | HOLLY KAI BREEDEN MD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 9835 N LAKE CREEK PKWY
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City | AUSTIN
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State | TX
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Zip | 78717-6210
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Country | US
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Telephone | 737-229-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 9835 N LAKE CREEK PKWY
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City | AUSTIN
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State | TX
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Zip | 78717-6210
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Country | US
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Telephone |
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Fax |
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | V2443
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License Number State | TX
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