Individual
DR. BOBBY N HOLSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2050A 2ND ST SE, KIRTLAND AFB, NM 87117-5103
(505) 846-3200
(575) 784-6028
Mailing address
855 FAIRWAY RD NW, ALBUQUERQUE, NM 87107-5720
(505) 379-0734
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
214
NM
103TC0700X
Clinical Psychologist
214
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00NM00N890
BC/BS OF NM
NM
01
—
201004465
PRESBYTERIAN HEALTH PLAN
NM
05
—
N6176
—
NM
Enumeration date
10/18/2006
Last updated
04/02/2021
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