Provider Demographics
NPI:1558636191
Name:HOLISTICA, LLC
Entity Type:Organization
Organization Name:HOLISTICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:XAVIER
Authorized Official - Middle Name:E
Authorized Official - Last Name:SANDOVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-840-0384
Mailing Address - Street 1:1980 POST OAK BLVD STE 1500
Mailing Address - Street 2:TWO POST OAK CENTRAL
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3845
Mailing Address - Country:US
Mailing Address - Phone:713-840-0384
Mailing Address - Fax:281-254-7911
Practice Address - Street 1:1980 POST OAK BLVD STE 1500
Practice Address - Street 2:1980 POST OAK BLVD, STE 1500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-3845
Practice Address - Country:US
Practice Address - Phone:713-840-0384
Practice Address - Fax:281-254-7911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-15
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory