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1548292360

NPI Code Detail

MEDICARE: LISA ROBIN HOLLOWAY D.O.

MEDICARE: LISA ROBIN HOLLOWAY D.O.

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	207P00000X	Emergency Medicine Physician	L3341	TX
2	207V00000X	Obstetrics & Gynecology Physician	L3341	TX
3	207Q00000X	Family Medicine Physician	L3341	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00846068	OTHER	TX	MEDICARE RAILROAD
4	P01030998	OTHER	TX	RR MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1548292360	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1548292360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA ROBIN HOLLOWAY D.O.

Provider Business Mailing Address
First Line	:	16605 SOUTHWEST FWY
Second Line	:	SUITE 400 MOB3
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-2345
Country	:	US
Telephone Number	:	281-275-0800
Fax Number	:	281-275-0801

Provider Business Practice Location Address
First Line	:	2150 W 18TH ST STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1289
Country	:	US
Telephone Number	:	713-426-0027
Fax Number	:	713-426-0211

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	02/06/2019

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Directions to “ LISA ROBIN HOLLOWAY D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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