Basic Information
| Provider Information | |||||||||
| NPI: | 1306352455 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RILEY | ||||||||
| FirstName: | HOLLY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8715 VILLAGE DR STE 305 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782175407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102267827 | ||||||||
| FaxNumber: | 2104336329 | ||||||||
| Practice Location | |||||||||
| Address1: | 8715 VILLAGE DR STE 605 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782175407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102267827 | ||||||||
| FaxNumber: | 2104336329 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/26/2017 | ||||||||
| LastUpdateDate: | 06/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.