Holladay, Lee Allen

Holladay, Lee Allen is an individual health care provider with primary practice located at 906 Judson Rd , Longview TX 75606-5113. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Holladay, Lee Allen can be contacted via phone (903) 655-1313.

Contact Information

Primary practice address
906 Judson Rd Longview TX 75606-5113
Phone: (903) 655-1313
Fax: (903) 657-6067
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 50892 Texas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 613235 Texas

Profile Details

NPI number 1821038019
LBN Legal business name Holladay, Lee Allen
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Mar 4th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821038019 NPPES
Texas MEDICAID 143839202

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