Provider Demographics
NPI:1316539547
Name:HOLTS, DIALLO
Entity Type:Individual
Prefix:
First Name:DIALLO
Middle Name:
Last Name:HOLTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10770 BARELY LN APT 913
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-5953
Mailing Address - Country:US
Mailing Address - Phone:337-930-6399
Mailing Address - Fax:
Practice Address - Street 1:10770 BARELY LN APT 913
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5953
Practice Address - Country:US
Practice Address - Phone:337-930-6399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport