Provider Demographics
NPI:1265245963
Name:PRYOR, HOLLY BUCHANAN
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:BUCHANAN
Last Name:PRYOR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16441 SPACE CENTER BLVD STE C100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2015
Mailing Address - Country:US
Mailing Address - Phone:281-480-7554
Mailing Address - Fax:281-480-4193
Practice Address - Street 1:16441 SPACE CENTER BLVD # C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2015
Practice Address - Country:US
Practice Address - Phone:281-480-7554
Practice Address - Fax:281-480-4193
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical