Provider Demographics
NPI:1457647653
Name:HOLLOWAY, BRANDON K (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:K
Last Name:HOLLOWAY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5109 LEXINGTON SQ STE 200
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6516
Mailing Address - Country:US
Mailing Address - Phone:806-322-3338
Mailing Address - Fax:806-322-7653
Practice Address - Street 1:5109 LEXINGTON SQ STE 200
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6516
Practice Address - Country:US
Practice Address - Phone:806-322-3338
Practice Address - Fax:806-322-7653
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-26
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT44-2011213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery