Provider Demographics
NPI:1457645855
Name:HOLT, BILL MICHAEL (ATP)
Entity Type:Individual
Prefix:MR
First Name:BILL
Middle Name:MICHAEL
Last Name:HOLT
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6931 WOODWAY DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6147
Mailing Address - Country:US
Mailing Address - Phone:254-772-6970
Mailing Address - Fax:888-775-2609
Practice Address - Street 1:6931 WOODWAY DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6147
Practice Address - Country:US
Practice Address - Phone:254-772-6970
Practice Address - Fax:888-775-2609
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP2253246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other