Organization
HOLLIWAY MEDICAL CLINIC LLC
Active
Other names
Holliway Pediatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRONDWYN ANN HOLLIWAY MD (PHYSICIAN)
(318) 635-8606
Entity
Organization
Contact information
Practice address
3824 HEARNE AVE, SHREVEPORT, LA 71103
(318) 635-8606
(318) 635-1265
Mailing address
3824 HEARNE AVE, SHREVEPORT, LA 71103
(318) 635-8606
(318) 635-1265
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
021100
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1449423
GROUP #
LA
05
—
1966207
—
LA
Enumeration date
02/02/2007
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up