Individual
KEVIN SCOTT HOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 S MAIN ST, FORT WORTH, TX 76104-4802
(817) 321-4900
Mailing address
1101 S MAIN ST, FORT WORTH, TX 76104-4802
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
165705
TX
Other
Enumeration date
01/17/2012
Last updated
01/17/2012
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