Organization
BETHSAIDA NEPHROLOGY AND INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLAYINKA OMOWUNMI HOLT MD (DIRECTOR)
(347) 350-3187
Entity
Organization
Contact information
Practice address
1405 JACAMAN RD STE 102, LAREDO, TX 78041-6225
(956) 568-9657
(956) 568-9659
Mailing address
1405 JACAMAN RD STE 102, LAREDO, TX 78041-6225
(956) 568-9657
(956) 568-9659
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P1765
TX
207RN0300X
Nephrology Physician
Primary
P1765
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
333074801
—
TX
Enumeration date
06/03/2013
Last updated
05/01/2018
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