MEDICARE: CAROLINE HOLLINGSWORTH M.D.

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	2085R0202X	Diagnostic Radiology Physician	CDR.0005940	CO
2	2085R0204X	Vascular & Interventional Radiology Physician	CDR.0005940	CO
3	2085N0904X	Nuclear Radiology Physician	CDR.0005940	CO
4	2085R0202X	Diagnostic Radiology Physician	K6471	TX
5	2085P0229X	Pediatric Radiology Physician	CDR.0005940	CO

General Provider Information

NPI Number	:	1528142684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE HOLLINGSWORTH M.D.

Provider Business Mailing Address
First Line	:	816 W CANNON ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3146
Country	:	US
Telephone Number	:	817-321-0404
Fax Number	:

Provider Business Practice Location Address
First Line	:	815 PENNSYLVANIA AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2224
Country	:	US
Telephone Number	:	817-321-0404
Fax Number	:

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	12/03/2025

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