Provider Demographics
NPI:1740258284
Name:HOLTZMAN, STEVEN FREDRIC (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:FREDRIC
Last Name:HOLTZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SHEPHERDS WAY
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:TX
Mailing Address - Zip Code:75032-7618
Mailing Address - Country:US
Mailing Address - Phone:214-538-6738
Mailing Address - Fax:972-771-0528
Practice Address - Street 1:6 SHEPHERDS WAY
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032-7618
Practice Address - Country:US
Practice Address - Phone:214-538-6738
Practice Address - Fax:972-771-0528
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7163207P00000X, 208600000X
KST-01994207P00000X
IL036046712207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0080PTOtherBCBS
TX0979221330Medicaid
KS200572350AMedicaid
IL036046712-1Medicaid
IL036046712-1Medicaid
KSKA1398018Medicare PIN
KS200572350AMedicaid
TX8L7662Medicare PIN
TX0979221330Medicaid
TXTXB127057Medicare PIN
D10204Medicare UPIN
TXD10204Medicare UPIN
KSKA1000013Medicare PIN