Provider Demographics
NPI:1639435233
Name:HOLLAND, TARA ASHLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:ASHLEY
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3041 MARTIN LUTHER KING DRIVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71107-4705
Mailing Address - Country:US
Mailing Address - Phone:318-227-3350
Mailing Address - Fax:318-222-2979
Practice Address - Street 1:1514 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-3379
Practice Address - Country:US
Practice Address - Phone:318-549-2500
Practice Address - Fax:318-741-8175
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2023-12-11
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Provider Licenses
StateLicense IDTaxonomies
LAMD.208054208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics