Provider Demographics
NPI:1235133836
Name:HOLMES, FAITH L (MD)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:L
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4107 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8660
Mailing Address - Country:US
Mailing Address - Phone:512-397-3360
Mailing Address - Fax:512-343-7101
Practice Address - Street 1:4107 SPICEWOOD SPRINGS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8660
Practice Address - Country:US
Practice Address - Phone:512-397-3360
Practice Address - Fax:512-343-7101
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8215207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE58189Medicare UPIN