Provider Demographics
NPI:1619983954
Name:HOLLIMAN, ANNA E (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:E
Last Name:HOLLIMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26726
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78755-0726
Mailing Address - Country:US
Mailing Address - Phone:512-407-8686
Mailing Address - Fax:512-421-4489
Practice Address - Street 1:2100 AUTUMN SLATE DR STE 150
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-6034
Practice Address - Country:US
Practice Address - Phone:737-220-7200
Practice Address - Fax:512-406-7340
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1343208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143721204Medicaid
TX143721205Medicaid
TX143721203Medicaid
TX143721206Medicaid
TX143721205Medicaid
TXTXB119132Medicare PIN
TX143721206Medicaid
TXTXB119133Medicare PIN