Provider Demographics
NPI:1134106651
Name:HOLMES, TERENCE S (MD)
Entity type:Individual
Prefix:
First Name:TERENCE
Middle Name:S
Last Name:HOLMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 515
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7311
Mailing Address - Country:US
Mailing Address - Phone:713-650-1900
Mailing Address - Fax:713-650-6368
Practice Address - Street 1:4140 SOUTHWEST FWY
Practice Address - Street 2:SUITE 515
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7311
Practice Address - Country:US
Practice Address - Phone:713-650-1900
Practice Address - Fax:713-650-6368
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE8568207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP086X9844Medicaid
8403K2Medicare ID - Type Unspecified
C17052Medicare UPIN