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Individual

MR. PRESCOTT BENTON HOLLAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
201 W TARRANT RD APT 1420, GRAND PRAIRIE, TX 75050-3583
(469) 684-1578
(214) 677-0079
Mailing address
PO BOX 532175, GRAND PRAIRIE, TX 75053
(469) 684-1578
(214) 677-0079

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Enumeration date
06/19/2013
Last updated
07/12/2013
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