Provider Demographics
NPI:1497049738
Name:HOLLY, APRIL MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:APRIL
Middle Name:MARIE
Last Name:HOLLY
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 1:1930 S AUSTIN AVE
Mailing Address - Street 2:STE. 105
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7840
Mailing Address - Country:US
Mailing Address - Phone:512-688-5476
Mailing Address - Fax:512-943-9824
Practice Address - Street 1:1930 S AUSTIN AVE
Practice Address - Street 2:STE. 105
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7840
Practice Address - Country:US
Practice Address - Phone:512-688-5476
Practice Address - Fax:512-943-9824
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11704111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB130428Medicare PIN