Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 22654 | TX |
N | 1223P0300X | Periodontist | 22654 | TX |
NPI | 1093809105 |
---|---|
Provider Name | Holland G Morrison |
First Address | Garland, TX 75044-6258 |
Second Address | Balch Springs, TX 75180-2325 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 23/06/2009 |