Provider Demographics
NPI:1205445103
Name:GURLEY, HOLLY
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:GURLEY
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 1:14850 QUORUM DR STE 400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-1445
Mailing Address - Country:US
Mailing Address - Phone:469-437-3564
Mailing Address - Fax:469-825-6903
Practice Address - Street 1:14850 QUORUM DR STE 400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-1445
Practice Address - Country:US
Practice Address - Phone:469-437-3564
Practice Address - Fax:469-825-6903
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX877791163W00000X
TX1032238367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse