Provider Demographics
NPI:1790750867
Name:GROFF, HOLLI ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:HOLLI
Middle Name:ANN
Last Name:GROFF
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21502 MERCHANTS WAY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2517
Mailing Address - Country:US
Mailing Address - Phone:281-944-2232
Mailing Address - Fax:281-944-2290
Practice Address - Street 1:1200 MCKINNEY ST STE 411
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77010-2038
Practice Address - Country:US
Practice Address - Phone:713-759-9449
Practice Address - Fax:713-759-6915
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1623152W00000X
MO2001030495152W00000X
TX5867TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX286741801Medicaid
TX501080YT4MMedicare PIN
TX286741801Medicaid
KSU81964Medicare UPIN
TXTXB140189Medicare PIN