Provider Demographics
NPI:1780660662
Name:HOLLAND, JOHN BYRL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BYRL
Last Name:HOLLAND
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0865
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:12222 MERIT DR STE 600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-3294
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3121207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125081302Medicaid
TX125081309Medicaid
TX125081303Medicaid
TX125081308Medicaid
TX83750KOtherBCBS
TX8EH083OtherBCBS
TX125081307Medicaid
TX050065908OtherRAILROAD
TX125081306Medicaid
TX125081310Medicaid
TX8EW780OtherBCBS
TX106191307Medicaid
TX125081305Medicaid
TX83750KMedicare PIN
TXTXB111121Medicare PIN
TX125081307Medicaid
TXTXB115897Medicare PIN
TX106191307Medicaid
TX340303YK6UMedicare PIN
TX8EH083OtherBCBS
TX262352YK6UMedicare PIN