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General NPI Number Information
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NPI Number | 1982038923
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Entity Type | Individual
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Provider Name | JON S HOLT CNIM
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Gender | Male
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Dates
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Enumeration Date | 08/27/2013
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 12337 JONES RD STE 427
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City | HOUSTON
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State | TX
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Zip | 77070-4951
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Country | US
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Telephone | 832-912-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 12337 JONES RD STE 427
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City | HOUSTON
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State | TX
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Zip | 77070-4951
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Country | US
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Telephone | 832-912-8600
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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 | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number | 2106
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number | 498
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License Number State |
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