MEDICARE: NANCY A HOULDER 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	207W00000X	Ophthalmology Physician	30959	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184686081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY A HOULDER MD

Provider Business Mailing Address
First Line	:	3900 E MEXICO AVE
Second Line	:	STE 102
City	:	DENVER
State	:	CO
Zip	:	80210-3940
Country	:	US
Telephone Number	:	720-524-1001
Fax Number	:	720-524-1121

Provider Business Practice Location Address
First Line	:	3900 E MEXICO AVE
Second Line	:	STE 102
City	:	DENVER
State	:	CO
Zip	:	80210-3940
Country	:	US
Telephone Number	:	720-524-1001
Fax Number	:	720-524-1121

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

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	10/19/2016

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