Provider Demographics
NPI:1467183889
Name:HOLDER, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:HOLDER
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 1:20518 S BLUE HYACINTH DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6697
Mailing Address - Country:US
Mailing Address - Phone:832-701-5179
Mailing Address - Fax:
Practice Address - Street 1:20518 S BLUE HYACINTH DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-6697
Practice Address - Country:US
Practice Address - Phone:832-701-5179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator