Provider Demographics
NPI:1184686081
Name:HOULDER, NANCY A (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:HOULDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 E MEXICO AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3940
Mailing Address - Country:US
Mailing Address - Phone:720-524-1001
Mailing Address - Fax:720-524-1121
Practice Address - Street 1:3900 E MEXICO AVE
Practice Address - Street 2:STE 102
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3940
Practice Address - Country:US
Practice Address - Phone:720-524-1001
Practice Address - Fax:720-524-1121
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO30959207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01309590Medicaid
COF82241Medicare UPIN
CO01309590Medicaid