Provider Demographics
NPI:1639282809
Name:HOLT, NASHA L (MD)
Entity Type:Individual
Prefix:DR
First Name:NASHA
Middle Name:L
Last Name:HOLT
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 1:14800 SAN PEDRO AVE
Mailing Address - Street 2:SUITE 222
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3733
Mailing Address - Country:US
Mailing Address - Phone:210-490-3500
Mailing Address - Fax:210-490-3510
Practice Address - Street 1:14800 SAN PEDRO AVE
Practice Address - Street 2:SUITE 222
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3733
Practice Address - Country:US
Practice Address - Phone:210-490-3500
Practice Address - Fax:210-490-3510
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4084207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1922011774OtherMEDICARE NPI