Provider Demographics
NPI:1386886703
Name:HOLDER, JANIE DARLENE (R EEG T, CNIM)
Entity type:Individual
Prefix:MRS
First Name:JANIE
Middle Name:DARLENE
Last Name:HOLDER
Suffix:
Gender:F
Credentials:R EEG T, CNIM
Other - Prefix:MS
Other - First Name:JANIE
Other - Middle Name:DARLENE
Other - Last Name:CUMBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REEGT, CNIM
Mailing Address - Street 1:10934 POWER SQUADRON RD.
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020
Mailing Address - Country:US
Mailing Address - Phone:817-368-1980
Mailing Address - Fax:817-406-8350
Practice Address - Street 1:10934 POWER SQUADRON RD.
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020
Practice Address - Country:US
Practice Address - Phone:817-368-1980
Practice Address - Fax:817-406-8350
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG