Provider Demographics
NPI:1952816399
Name:HOLMAN, TONYA MECHELE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:MECHELE
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:MECHELE
Other - Last Name:HOLMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2324 MAXWELL CIR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-2219
Mailing Address - Country:US
Mailing Address - Phone:409-221-2156
Mailing Address - Fax:
Practice Address - Street 1:2324 MAXWELL CIR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-2219
Practice Address - Country:US
Practice Address - Phone:409-221-2156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134108363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health