Provider Demographics
NPI:1205254786
Name:HOLIDAY, VERONICA ANNETTE (BACHELOR OF SCIENCE)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:ANNETTE
Last Name:HOLIDAY
Suffix:
Gender:F
Credentials:BACHELOR OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 11 ALCALA
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77078
Mailing Address - Country:US
Mailing Address - Phone:832-790-3763
Mailing Address - Fax:
Practice Address - Street 1:9049 BRANDON
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77051
Practice Address - Country:US
Practice Address - Phone:713-734-4431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX798000000Medicaid