Organization
RSS JON HOLMAN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES R EVANGER (CEO)
(904) 469-3119
Entity
Organization
Contact information
Practice address
13301 N MERIDIAN AVE, BLDG 100, SUITE 100, OKLAHOMA CITY, OK 73120-9369
(405) 486-7879
(855) 829-4625
Mailing address
1050 TEXAN TRL, SUITE 300, GRAPEVINE, TX 76051-3741
(469) 778-6100
(866) 300-4682
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4246
OK
332B00000X
Durable Medical Equipment & Medical Supplies
—
OK
Other
Enumeration date
11/07/2016
Last updated
10/16/2017
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