MEDICARE: KATHARINE MICHELE HOLT PA

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	363A00000X	Physician Assistant	PA11655	TX

General Provider Information

NPI Number	:	1023521556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHARINE MICHELE HOLT PA

Provider Business Mailing Address
First Line	:	PO BOX 679191
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75267-9191
Country	:	US
Telephone Number	:	972-316-4555
Fax Number	:	469-802-1548

Provider Business Practice Location Address
First Line	:	6000 W SPRING CREEK PKWY STE 200
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-3617
Country	:	US
Telephone Number	:	972-316-4555
Fax Number	:	972-378-9996

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

Provider Enumeration Date	:	11/06/2017
Last Update Date	:	01/13/2025

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