Provider Demographics
NPI:1710436621
Name:TERRELL OBGYN CLINIC-HOLLIS PLLC
Entity Type:Organization
Organization Name:TERRELL OBGYN CLINIC-HOLLIS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:PHIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-454-1722
Mailing Address - Street 1:3900 JOE RAMSEY BLVD E
Mailing Address - Street 2:STE E
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-7727
Mailing Address - Country:US
Mailing Address - Phone:903-454-1722
Mailing Address - Fax:903-454-1750
Practice Address - Street 1:109 TEJAS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-6676
Practice Address - Country:US
Practice Address - Phone:972-563-3334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8191207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty