MEDICARE: ELIZABETH GUN-WHA HOLT MD

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	207R00000X	Internal Medicine Physician	38972	KY
2	207RG0100X	Gastroenterology Physician	38972	KY
3	207RG0100X	Gastroenterology Physician	T7947	TX

General Provider Information

NPI Number	:	1053409318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH GUN-WHA HOLT MD

Provider Business Mailing Address
First Line	:	1302 MILFORD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-6318
Country	:	US
Telephone Number	:	859-608-0418
Fax Number	:	859-257-9287

Provider Business Practice Location Address
First Line	:	6400 FANNIN ST STE 1400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1512
Country	:	US
Telephone Number	:	713-704-5968
Fax Number	:

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	05/29/2025

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