Provider Demographics
NPI:1780757245
Name:HOLLAND, CHARLES E (PHD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:E
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:400 W MAIN
Mailing Address - Street 2:#212
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664
Mailing Address - Country:US
Mailing Address - Phone:512-341-0021
Mailing Address - Fax:512-759-1608
Practice Address - Street 1:400 W MAIN
Practice Address - Street 2:#212
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664
Practice Address - Country:US
Practice Address - Phone:512-341-0021
Practice Address - Fax:512-759-1608
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX268902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6144777OtherUNITED BEHAVIORAL HEALTH
TX158753OtherVALUE OPTIONS
TX0027EFOtherBCBS