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Tina Dawn Holley

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

333 N Santa Rosa, San Antonio, TX 78207-3108

PECOS Enrollment

This provider is enrolled in PECOS as TINA HOLLEY.

Based on the most recent information from CMS, provider Tina Dawn Holley is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1891208377
Provider Type
Individual
Full Name
Holley, Tina Dawn
Gender
Female

Sole Proprietor
No
Enumeration Date
11/7/2017
Last Updated
1/31/2023

Contact Information

Practice Location

333 N Santa Rosa, San Antonio, TX 78207-3108

(830) 643-6140

Unlisted Fax

Mailing Location

315 N San Saba Ste 1135, San Antonio, TX 78207-3255

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License AP135757 Texas

Tina Dawn Holley

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Dienhart, Danielle Jaye

Estrada, Brittany Ann

Elo, Lyannette Calderon

Shaw-Guzman, Stephanie Marie

Azua, Adrianna Nicole

Porter, Vanessa Roy

Garcia, Donna L.

Thies, Marita Silvia

Rodriguez, Melissa

Hadley, Nancy