Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | M6590 | TX |
N | 2084N0402X | Child Neurologist | M6590 | TX |
NPI | 1023226586 |
---|---|
Provider Name | Holly N Dudley-Harrell |
First Address | Houston, TX 77030-2303 |
Second Address | Houston, TX 77030-2303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 26/08/2008 |