MEDICARE: STEPHEN DANIEL HOLLEK DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1237226	TX

General Provider Information

NPI Number	:	1023447497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN DANIEL HOLLEK DPT

Provider Business Mailing Address
First Line	:	1919 GRAYSTONE HILLS DR
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77304-2336
Country	:	US
Telephone Number	:	281-639-5792
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 N LOOP 336 W
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77301-1156
Country	:	US
Telephone Number	:	936-494-3777
Fax Number	:	936-494-3788

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2013
Last Update Date	:	06/22/2023

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