Provider Demographics
NPI:1588868152
Name:HOLMES, MICHAEL CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHRISTOPHER
Last Name:HOLMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:104 SEMINOLE CANYON DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-7193
Mailing Address - Country:US
Mailing Address - Phone:504-813-7701
Mailing Address - Fax:
Practice Address - Street 1:1464 E WHITESTONE BLVD
Practice Address - Street 2:SUITE 901
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-9058
Practice Address - Country:US
Practice Address - Phone:512-260-8100
Practice Address - Fax:512-260-8103
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3736208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
3891389970OtherMYUTMB 3891389970-COMMERCIAL NUMBER