Individual
HOLLY M BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1201 ARISTA DR STE 105, ROCKWALL, TX 75032-6860
(972) 664-0644
(972) 664-0301
Mailing address
1201 ARISTA DR STE 105, ROCKWALL, TX 75032-6860
(972) 664-0644
(972) 664-0301
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
0001699
MT
207RR0500X
Rheumatology Physician
01083639A
IN
207RR0500X
Rheumatology Physician
17322
AL
207RR0500X
Rheumatology Physician
Primary
Q9950
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000042537
HEALTHSPRING
AL
01
—
000085151
BLUE CROSS
AL
05
—
000085151
—
AL
01
—
660000333
RAILROAD MEDICARE
AL
01
—
F42171
VIVA
AL
Enumeration date
05/23/2006
Last updated
09/13/2021
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