Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | F5234 | TX |
NPI | 1023002698 |
---|---|
Provider Name | Dr. Charles A Holshouser JR. |
First Address | San Antonio, TX 78229-3711 |
Second Address | San Antonio, TX 78229-3711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2005 |
Last Update Date | 10/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100256002 | (05) | TX |
C17061 | (02) |