Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | E9236 | TX |
NPI | 1114942414 |
---|---|
Provider Name | Dr. Joseph R. Holahan |
First Address | San Antonio, TX 78229-3307 |
Second Address | San Antonio, TX 78229-3307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 14/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
128565206 | (05) | TX |
4240685 | AETNA PIN# (01) | |
C17014 | (02) |