Provider Demographics
NPI:1821223496
Name:TOBIN HOLLOWAY, O.D., P.C.
Entity Type:Organization
Organization Name:TOBIN HOLLOWAY, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TOBIN
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:806-288-0400
Mailing Address - Street 1:1303 GARLAND ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-4623
Mailing Address - Country:US
Mailing Address - Phone:806-288-0400
Mailing Address - Fax:806-288-0401
Practice Address - Street 1:1501 N I-27
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-3916
Practice Address - Country:US
Practice Address - Phone:806-288-0400
Practice Address - Fax:806-288-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4485T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019404501Medicaid