Individual
LEE ALLEN HOLLADAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
906 JUDSON RD, LONGVIEW, TX 75606-5113
(903) 655-1313
(903) 657-6067
Mailing address
P.O. BOX 2527, LONGVIEW, TX 75606-2527
(903) 655-1313
(903) 657-6067
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
50892
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
613235
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143839202
—
TX
Enumeration date
06/07/2006
Last updated
03/04/2009
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