Provider Demographics
NPI:1255752804
Name:HOLLOWAY, MADELEINE ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:ELIZABETH
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MADELEINE
Other - Middle Name:ELIZABETH
Other - Last Name:MULLINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1600 PROVIDENCE DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76707-2261
Mailing Address - Country:US
Mailing Address - Phone:254-313-4200
Mailing Address - Fax:254-313-4549
Practice Address - Street 1:1600 PROVIDENCE DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76707-2261
Practice Address - Country:US
Practice Address - Phone:254-313-4200
Practice Address - Fax:254-313-4531
Is Sole Proprietor?:No
Enumeration Date:2013-12-29
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant