Provider Demographics
NPI:1053823344
Name:HOLIDAY'S FAMILY MEDICAL CLINIC
Entity Type:Organization
Organization Name:HOLIDAY'S FAMILY MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:H
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:832-286-4459
Mailing Address - Street 1:16300 KUYKENDAHL RD STE 410
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-2751
Mailing Address - Country:US
Mailing Address - Phone:832-286-4459
Mailing Address - Fax:832-286-4361
Practice Address - Street 1:17007 DAWN SHADOWS DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-4547
Practice Address - Country:US
Practice Address - Phone:832-643-9116
Practice Address - Fax:832-643-9116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty