Provider Demographics
NPI:1750566949
Name:HOLMES, JUDY F (LPT)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:F
Last Name:HOLMES
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8226 DOUGLAS
Mailing Address - Street 2:SUITE 435
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5999
Mailing Address - Country:US
Mailing Address - Phone:214-368-3511
Mailing Address - Fax:214-368-1810
Practice Address - Street 1:8226 DOUGLAS
Practice Address - Street 2:SUITE 435
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5999
Practice Address - Country:US
Practice Address - Phone:214-368-3511
Practice Address - Fax:214-368-1810
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1016947225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4396539OtherAETNA
TX4396539OtherAETNA