Doctor Name: | MISS SHERBY PATRICE HOLLOWAY |
NPI Number: | 1023263233 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | PA05561 |
Business Practice Address: | 1107 E Marshall Ave Longview, TX - 756015602 |
Business Phone Number: | 9037582610 |
Business Fax Number: | 9037583124 |
Mailing Address: | 1107 E Marshall Ave, LONGVIEW |
State: | TX |
Postal Code: | 756015602 |
Phone Number: | 9037582610 |
Fax Number: | 9037583124 |
NPI Enumeration Date: | 12/02/2008 |
NPI Last Update Date: | 12/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA05561 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |