Provider Demographics
NPI:1891211520
Name:WESTBROOK, HOLLY ANN
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 PEPPERMILL RUN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1932
Mailing Address - Country:US
Mailing Address - Phone:830-556-8071
Mailing Address - Fax:830-323-0178
Practice Address - Street 1:2718 PEPPERMILL RUN ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1932
Practice Address - Country:US
Practice Address - Phone:830-556-8071
Practice Address - Fax:830-323-0178
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2022-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132764367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife