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NPI Code Detail

MEDICARE: TIMOTHY L HOLCOMB D.O.

MEDICARE: TIMOTHY L HOLCOMB 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
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine PhysicianP7464TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
175-2616977-029OTHERTXTRICARE
28FE338OTHERTXBCBS
375-2616977-002OTHERTXTRICARE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609138486
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY L HOLCOMB D.O.
Provider Business Mailing Address
First Line : PO BOX 846098
Second Line :
City : DALLAS
State : TX
Zip : 75284-6098
Country : US
Telephone Number : 903-324-6400
Fax Number :
Provider Business Practice Location Address
First Line : 20208 ST HWY 155 S
Second Line :
City : FLINT
State : TX
Zip : 75762-5600
Country : US
Telephone Number : 903-825-6222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2012
Last Update Date : 10/31/2015

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Directions to “ TIMOTHY L HOLCOMB D.O.” Practice Location

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