Provider Demographics
NPI:1083047005
Name:TRANTHAM, HOLLY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:
Last Name:TRANTHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 KENSINGTON LN
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-1706
Mailing Address - Country:US
Mailing Address - Phone:210-262-0041
Mailing Address - Fax:
Practice Address - Street 1:1707 WEST 8TH STREET
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79763-3423
Practice Address - Country:US
Practice Address - Phone:432-332-8258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53597183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist