1033307012 NPI number — DR. HOLLY LYNN HOFFMAN-ROBERTS PHARM.D.

Table of content: DR. HOLLY LYNN HOFFMAN-ROBERTS PHARM.D. (NPI 1033307012)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033307012 NPI number — DR. HOLLY LYNN HOFFMAN-ROBERTS PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOFFMAN-ROBERTS
Provider First Name:
HOLLY
Provider Middle Name:
LYNN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033307012
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4500 S LANCASTER RD
Provider Second Line Business Mailing Address:
VA MEDICAL CENTER BLD 7, R# 119A
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75216-7167
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-372-5300
Provider Business Mailing Address Fax Number:
214-375-9366

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4500 S LANCASTER RD
Provider Second Line Business Practice Location Address:
VA MEDICAL CENTER BLD 7, R# 119A
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75216-7167
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-372-5300
Provider Business Practice Location Address Fax Number:
214-375-9366
Provider Enumeration Date:
10/04/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  45737 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: 11311 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: 12948 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)