1497716401 NPI number — PAUL Y HOLOYE M. D.

Table of content: PAUL Y HOLOYE M. D. (NPI 1497716401)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497716401 NPI number — PAUL Y HOLOYE M. D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLOYE
Provider First Name:
PAUL
Provider Middle Name:
Y
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M. D.
Provider Gender Code:
M

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:
1497716401
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 720878
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78504-0878
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-217-7000
Provider Business Mailing Address Fax Number:
566-821-6689

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5401 N G ST STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCALLEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-217-7000
Provider Business Practice Location Address Fax Number:
956-682-1668
Provider Enumeration Date:
03/29/2006

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: 207RH0003X , with the licence number:  D9170 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 139055103 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 25206 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2317059 . This is a "BLUE LINK #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 900002644 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10014446 . This is a "AMERICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 139055107 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4138683 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 85273N . This is a "BLUECHOICE SOLUTION NETWK" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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