Basic Information
| Provider Information | |||||||||
| NPI: | 1154358281 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOLLIER | ||||||||
| FirstName: | ROYCE | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8907 HEADSTALL DR | ||||||||
| Address2: | |||||||||
| City: | TOMBALL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773754404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3373491629 | ||||||||
| FaxNumber: | 3379819257 | ||||||||
| Practice Location | |||||||||
| Address1: | 5656 KELLEY STRRET | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135665971 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 06/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | AP04939 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 8052939 | 05 | NC | MEDICAID | 1712710 | 05 | LA | MEDICAID |