Provider Demographics
NPI:1316167133
Name:MOLLGAARD, HOLLY BROWNE (DPM)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:BROWNE
Last Name:MOLLGAARD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:LEIGH
Other - Last Name:BROWNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:15010 STONETOWER DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-2705
Mailing Address - Country:US
Mailing Address - Phone:210-385-6959
Mailing Address - Fax:830-620-6888
Practice Address - Street 1:1004 MISSION DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6129
Practice Address - Country:US
Practice Address - Phone:830-625-8200
Practice Address - Fax:830-620-6888
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1808213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery