Basic Information
| Provider Information | |||||||||
| NPI: | 1205140480 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRACY | ||||||||
| FirstName: | HOLLY | ||||||||
| MiddleName: | DEANN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 W 5TH ST | ||||||||
| Address2: | |||||||||
| City: | ODESSA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 797634206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4323355233 | ||||||||
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| Practice Location | |||||||||
| Address1: | 77 CADILLAC DR STE 230 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958255480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9169202082 | ||||||||
| FaxNumber: | 9166898943 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2010 | ||||||||
| LastUpdateDate: | 10/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | BP10038818 | TX | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.