Provider Demographics
NPI:1285728162
Name:JAMES F. HOLLEMAN, III, MD, PA
Entity type:Organization
Organization Name:JAMES F. HOLLEMAN, III, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FINAS
Authorized Official - Last Name:HOLLEMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:903-526-2323
Mailing Address - Street 1:2708 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-5021
Mailing Address - Country:US
Mailing Address - Phone:903-526-2323
Mailing Address - Fax:903-526-2484
Practice Address - Street 1:2708 E 5TH ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-5021
Practice Address - Country:US
Practice Address - Phone:903-526-2323
Practice Address - Fax:903-526-2484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3241207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167503501Medicaid
TXDA4810OtherGROUP RAILROAD MEDICARE
TX167503501Medicaid