Provider Demographics
NPI:1326087040
Name:HOLSTER, TERRY ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ALLEN
Last Name:HOLSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4660 SWEETWATER BLVD
Mailing Address - Street 2:SUITE NO. 190
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3011
Mailing Address - Country:US
Mailing Address - Phone:281-494-4004
Mailing Address - Fax:281-494-8899
Practice Address - Street 1:4660 SWEETWATER BLVD
Practice Address - Street 2:SUITE NO. 190
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3011
Practice Address - Country:US
Practice Address - Phone:281-494-4004
Practice Address - Fax:281-494-8899
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM2980207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F4929Medicare PIN
TXI72364Medicare UPIN