Provider Demographics
NPI:1598066185
Name:HOLISTIC OPTIMAL HEALTH CENTER LLC
Entity Type:Organization
Organization Name:HOLISTIC OPTIMAL HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:NANJAPPA
Authorized Official - Middle Name:
Authorized Official - Last Name:SREENIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-444-0111
Mailing Address - Street 1:3701 W BUSINESS 83
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-3521
Mailing Address - Country:US
Mailing Address - Phone:956-444-0111
Mailing Address - Fax:956-444-0113
Practice Address - Street 1:3701 W BUSINESS 83
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-3556
Practice Address - Country:US
Practice Address - Phone:956-444-0111
Practice Address - Fax:956-444-0113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & AdolescentGroup - Multi-Specialty