MEDICARE: LAURIE S HOLLEY 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	J6495	TX

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700848983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE S HOLLEY MD

Provider Business Mailing Address
First Line	:	ONE BAYLOR PLAZA
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-3411
Country	:	US
Telephone Number	:	281-554-7031
Fax Number	:	832-355-4232

Provider Business Practice Location Address
First Line	:	4600 E SAM HOUSTON PKWY SOUTH
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77505
Country	:	US
Telephone Number	:	713-785-8357
Fax Number	:	713-798-5838

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

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	02/28/2024

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Directions to “ LAURIE S HOLLEY MD” Practice Location

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