Provider Demographics
NPI:1790061042
Name:HOLLAND, BRIAN (OTR)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 DOVE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6643
Mailing Address - Country:US
Mailing Address - Phone:213-804-4327
Mailing Address - Fax:
Practice Address - Street 1:2401 DOVE CREEK DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-6643
Practice Address - Country:US
Practice Address - Phone:213-804-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9124225X00000X
TX116578225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist