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General NPI Number Information
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NPI Number | 1699835637
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Entity Type | Individual
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Provider Name | KERRY THOMAS HOLT O.D.
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10710 GATEWAY BLVD N STE B-10
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City | EL PASO
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State | TX
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Zip | 79924-1739
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Country | US
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Telephone | 915-821-6800
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Fax | 915-822-8282
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Provider Business Mailing Address
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Address Line | 10816 LOMA DE VIDA LN
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City | EL PASO
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State | TX
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Zip | 79934-3780
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Country | US
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Telephone | 915-241-2030
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Fax | 915-822-8282
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5632TG
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License Number State | TX
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