Individual
WANDA HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
3901 W 15TH ST, PLANO, TX 75075-7738
(817) 294-7444
Mailing address
PO BOX 118932, CARROLLTON, TX 75011-8932
(817) 294-7444
(817) 294-7172
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048644
CST
TX
Enumeration date
10/30/2007
Last updated
10/30/2007
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