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General NPI Number Information
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NPI Number | 1881628063
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Entity Type | Organization
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Legal Business Name | KENNETH HOLLIS, M.D., P.A.
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 119 W PARKWOOD AVE
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-5420
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Country | US
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Telephone | 281-482-4300
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Fax | 281-482-3159
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Provider Business Mailing Address
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Address Line | PO BOX 58869
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City | WEBSTER
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State | TX
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Zip | 77598-8869
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Country | US
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Telephone | 713-850-1190
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Fax | 713-850-1327
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Authorized Official
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Title or Position | DIRECTOR
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Name | KENNETH W HOLLIS
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Credential | MD
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Telephone | 713-850-1190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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