Provider Demographics
NPI:1275579799
Name:HOLT, ANDREW FOY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:FOY
Last Name:HOLT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 35629
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0629
Mailing Address - Country:US
Mailing Address - Phone:214-424-2213
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:4370 MEDICAL ARTS DR
Practice Address - Street 2:STE 295
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1712
Practice Address - Country:US
Practice Address - Phone:972-691-3777
Practice Address - Fax:972-691-3666
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8G6503207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188614501Medicaid
TXM3264OtherMEDICAL LICENSE
TX8V3547OtherBCBS
TX188614501Medicaid
TX8G6503Medicare PIN