Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | M6196 | TX |
NPI | 1043438450 |
---|---|
Provider Name | Dudley Byron Holt |
First Address | Austin, TX 78722-2211 |
Second Address | Austin, TX 78722-2211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 27/10/2010 |