Organization
FAMILY MEDICAL CLINIC OF MESQUITE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL D. HOLLIDAY D.O. (OWNER)
(972) 279-6595
Entity
Organization
Contact information
Practice address
2540 N GALLOWAY AVE, SUITE 103, MESQUITE, TX 75150-6306
(972) 279-6595
(972) 613-3737
Mailing address
2540 N GALLOWAY AVE, SUITE 103, MESQUITE, TX 75150-6306
(972) 279-6595
(972) 613-3737
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D3614
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201526501
—
TX
01
—
DP1469
MEDICARE RAIL ROAD
TX
Enumeration date
06/13/2008
Last updated
11/13/2014
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