Provider Demographics
NPI:1326570128
Name:HOLLAND, CARESSA CATHERINE (DC)
Entity Type:Individual
Prefix:DR
First Name:CARESSA
Middle Name:CATHERINE
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TROPHY CLUB
Mailing Address - State:TX
Mailing Address - Zip Code:76262-4209
Mailing Address - Country:US
Mailing Address - Phone:817-239-6977
Mailing Address - Fax:
Practice Address - Street 1:404 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:TROPHY CLUB
Practice Address - State:TX
Practice Address - Zip Code:76262-4209
Practice Address - Country:US
Practice Address - Phone:817-239-6977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6266111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor