Individual
DESIREE HOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
390 SABINE STREET, SUITE D, HEMPHILL, TX 75948-7065
(409) 787-0006
(409) 787-0008
Mailing address
390 SABINE STREET, SUITE D, HEMPHILL, TX 75948-7065
(409) 787-0006
(409) 787-0008
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03982
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
335469801
—
TX
05
—
335469802
—
TX
05
—
335469803
—
TX
05
—
335469804
—
TX
01
—
75-0818167-015
TRICARE
TX
01
—
75-0818167-022
TRICARE
TX
01
—
75-0818167-044
TRICARE
TX
01
—
75-0818167-048
TRICARE
TX
01
—
75-1976930-005
TRICARE
TX
01
—
75-2616977-001
TRICARE
TX
01
—
75-2616977-002
TRICARE
TX
01
—
75-2616977-028
TRICARE
TX
01
—
8283ND
BCBS
—
01
—
8285ND
BCBS
TX
01
—
8286ND
BCBS
TX
01
—
8812NF
BCBS
TX
01
—
P01290918
RAIL ROAD
TX
Enumeration date
01/17/2007
Last updated
03/23/2017
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