Provider Demographics
NPI:1447233606
Name:HOLLOWAY, TOBIN NEIL (OD)
Entity Type:Individual
Prefix:DR
First Name:TOBIN
Middle Name:NEIL
Last Name:HOLLOWAY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 GARLAND ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-4623
Mailing Address - Country:US
Mailing Address - Phone:806-288-0400
Mailing Address - Fax:806-288-0401
Practice Address - Street 1:1501 N I-27
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072
Practice Address - Country:US
Practice Address - Phone:806-288-0400
Practice Address - Fax:806-288-0401
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4485T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019404501Medicaid
TX019404501Medicaid
TX00E56SMedicare ID - Type Unspecified