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NPI Code Detail

MEDICARE: HOLLY ANNE LAWRENCE PSYD

MEDICARE: HOLLY ANNE LAWRENCE PSYD
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
1103TC0700XClinical Psychologist31117TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00295323OTHERTXRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
387163AOTHERTXBCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760436638
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY ANNE LAWRENCE PSYD
Provider Business Mailing Address
First Line : 14785 PRESTON RD
Second Line : STE 550
City : DALLAS
State : TX
Zip : 75254-7899
Country : US
Telephone Number : 214-727-0260
Fax Number :
Provider Business Practice Location Address
First Line : 1801 PEARSON AVE
Second Line :
City : MCKINNEY
State : TX
Zip : 75069-3464
Country : US
Telephone Number : 214-727-0260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2006
Last Update Date : 02/25/2020

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