Provider Demographics
NPI:1780011882
Name:HOLIDAY, LARRY J (CRT)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:J
Last Name:HOLIDAY
Suffix:
Gender:M
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 PRESTON PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5119
Mailing Address - Country:US
Mailing Address - Phone:972-818-3888
Mailing Address - Fax:972-818-3889
Practice Address - Street 1:1901 PRESTON PARK BLVD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5119
Practice Address - Country:US
Practice Address - Phone:972-818-3888
Practice Address - Fax:972-818-3889
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52278227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified