MEDICARE: KENDRA L HOLLEMAN RMA, CPT

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	246RP1900X	Phlebotomy Technician

General Provider Information

NPI Number	:	1861344723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDRA L HOLLEMAN RMA, CPT

Provider Business Mailing Address
First Line	:	3704 TULIP TREE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-6067
Country	:	US
Telephone Number	:	817-719-7169
Fax Number	:	817-719-7169

Provider Business Practice Location Address
First Line	:	3704 TULIP TREE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-6067
Country	:	US
Telephone Number	:	817-719-7169
Fax Number	:	817-719-7169

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

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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