Individual
ETHAN JACOB HOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
420 E UNIVERSITY DR, DENTON, TX 76209-2095
(580) 630-5806
Mailing address
3789 OLD HIGHWAY 70, ARDMORE, OK 73401-0577
(940) 297-6500
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
P9L2R2C7
OK
Other
Enumeration date
11/05/2025
Last updated
11/05/2025
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