Provider Demographics
NPI:1588993224
Name:JULIE A HOLMES, OD, PLLC
Entity type:Organization
Organization Name:JULIE A HOLMES, OD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:918-935-3500
Mailing Address - Street 1:9 E 4TH ST
Mailing Address - Street 2:STE #105
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74103-5103
Mailing Address - Country:US
Mailing Address - Phone:918-935-3500
Mailing Address - Fax:918-935-3501
Practice Address - Street 1:9 E 4TH ST
Practice Address - Street 2:STE #105
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-5103
Practice Address - Country:US
Practice Address - Phone:918-935-3500
Practice Address - Fax:918-935-3501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2531152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKB5970Medicare PIN