Individual
THERESE ANN HOLGUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1490 N TURQUOISE DR, FLAGSTAFF, AZ 86001-1383
(928) 774-5074
(928) 779-0884
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
19361
AZ
207N00000X
Dermatology Physician
88-191
NM
207ND0101X
MOHS-Micrographic Surgery Physician
19361
AZ
207NS0135X
Procedural Dermatology Physician
19361
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070002910
RXR MEDICARE
AZ
05
—
295114
—
AZ
Enumeration date
07/12/2006
Last updated
06/19/2025
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