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Individual

BRANDI L HOLCOMB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACNP

Contact information

Practice address
703 S FLEISHEL AVE, STE 5000, TYLER, TX 75701-2015
(903) 525-2992
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP131448
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
364256301
TX
01
75-2616977-123
TRICARE
TX
01
8334NY
BCBS
TX
01
P01707515
RAIL ROAD MEDICARE
TX
Enumeration date
07/12/2016
Last updated
12/09/2016
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