Basic Information
| Provider Information | |||||||||
| NPI: | 1578071338 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAMES G. HOLCOMB, CRNA, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11609 WIND CREEK CT | ||||||||
| Address2: | |||||||||
| City: | ALEDO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760083683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3256756466 | ||||||||
| FaxNumber: | 3256926030 | ||||||||
| Practice Location | |||||||||
| Address1: | 5601 HEALTH CENTER DR | ||||||||
| Address2: | |||||||||
| City: | ABILENE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 796061225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3256756466 | ||||||||
| FaxNumber: | 3256926030 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2018 | ||||||||
| LastUpdateDate: | 01/26/2018 | ||||||||
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| AuthorizedOfficialLastName: | WALKER | ||||||||
| AuthorizedOfficialFirstName: | POPPY | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | BUSINESS OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3256756466 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MBA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 50890 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.