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General NPI Number Information
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NPI Number | 1689132540
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Entity Type | Organization
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Legal Business Name | MICHAEL C. HOLMES, MD, PLLC
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Dates
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Enumeration Date | 03/08/2019
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Last Update Date | 03/08/2019
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Provider Practice Location Address
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Address Line | 1464 E WHITESTONE BLVD STE 2104
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City | CEDAR PARK
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State | TX
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Zip | 78613-9079
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Country | US
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Telephone | 512-260-8100
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Fax | 512-260-8103
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Provider Business Mailing Address
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Address Line | 1464 E WHITESTONE BLVD STE 2104
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City | CEDAR PARK
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State | TX
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Zip | 78613-9079
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Country | US
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Telephone | 512-260-8100
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Fax | 512-260-8103
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | MICHAEL HOLMES
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Credential | MD
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Telephone | 504-813-7701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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