Provider Demographics
NPI:1457797797
Name:HOLMES, PAIGE A (ANP-C)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:A
Last Name:HOLMES
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5461 LA SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4107
Mailing Address - Country:US
Mailing Address - Phone:214-692-8541
Mailing Address - Fax:214-242-1035
Practice Address - Street 1:7720 EL PASTEL DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-3121
Practice Address - Country:US
Practice Address - Phone:214-412-7750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP123361363LA2200X
TX774827363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health