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NPI Code Detail

MEDICARE: TINA DAWN HOLLEY

MEDICARE: TINA DAWN HOLLEY
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
1363LF0000XFamily Nurse PractitionerAP135757TX

General Provider Information

NPI Number : 1891208377
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA DAWN HOLLEY
Provider Business Mailing Address
First Line : 315 N SAN SABA STE 1135
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78207-3255
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 333 N SANTA ROSA
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78207-3108
Country : US
Telephone Number : 830-643-6140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2017
Last Update Date : 02/20/2026

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