Individual
MR. ISAAC DERYL OVERHOLTZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
36065 SANTA FE AVE, FORT HOOD, TX 76544-5060
(254) 553-3147
Mailing address
679 FM 2808 # 7, KEMPNER, TX 76539-5744
(254) 577-0681
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
10966491-3101
UT
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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