Provider Demographics
NPI:1902177603
Name:PRESLAR, HOLLY D (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:D
Last Name:PRESLAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15411 CORAL CYN
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-3905
Mailing Address - Country:US
Mailing Address - Phone:405-464-2488
Mailing Address - Fax:
Practice Address - Street 1:800 RIVERWOOD CT
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2890
Practice Address - Country:US
Practice Address - Phone:936-760-4454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2063363A00000X
TXPA07964363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant