MR. LARRY FULTON HOLMAN JR. (NPI# 1225550932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225550932 |
| Entity Type | Individual |
| Full Name | MR. LARRY FULTON HOLMAN JR. |
| Credential | FNP |
| Practice Address |
709 Hollybrook Dr Longview TX 75605-2411 |
| Mailing Address |
115 Shawnee Trl Hallsville TX 75650-5014 |
| Practice Telephone | 9037574691 |
| Mailing Telephone | 9036600395 |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2020-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP134397 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174687941 | Larry Holman | Marriage & Family Therapist | 1407 W 31st Ave, Suite 602, Anchorage, AK 99503-3678 | 2006-12-19 |
| Street Address |
709 HOLLYBROOK DR |
| City | LONGVIEW |
| State | TX |
| Zip Code | 75605-2411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992781090 | Sanford Watkins | Emergency Medicine | 709 Hollybrook Dr, Suite 4500, Longview, TX 75605-2411 | 2005-12-20 |
| 1184159055 | Ryan M Guillory Md Pa | Pediatrics | 709 Hollybrook Dr, Suite 5605, Longview, TX 75605-2411 | 2017-04-27 |
| 1447524558 | Sau Chi Goretti Lau | Pharmacist | 709 Hollybrook Dr, Suite 100, Longview, TX 75605-2411 | 2012-03-07 |
| 1891095717 | Kristy Loftin-moening | Audiologist | 709 Hollybrook Dr, Suite 5601, Longview, TX 75605-2411 | 2010-10-26 |
| 1093973661 | Jorge Eduardo Massare-rodriguez | Specialist | 709 Hollybrook Dr, Suite 2301, Longview, TX 75605-2411 | 2008-05-29 |
| 1235333808 | Jonathan David Greifenkamp | Internal Medicine | 709 Hollybrook Dr, Suite 2301, Longview, TX 75605-2411 | 2007-06-14 |
| 1407050008 | Kathleen Weindorff Harris | Internal Medicine | 709 Hollybrook Dr, Suite 4500, Longview, TX 75605 | 2007-06-14 |
| 1366646564 | Action Medsource LLC. | Durable Medical Equipment & Medical Supplies | 709 Hollybrook Dr, Suite 3401, Longview, TX 75605-2411 | 2007-06-12 |
| 1447451406 | Diagnostic Clinic of Longview Pharmacy | Pharmacist | 709 Hollybrook Dr, Suite 4500, Longview, TX 75605-2411 | 2007-05-29 |
| 1972713782 | Phyllis Cary | Pharmacist | 709 Hollybrook Dr, Suite 4500, Longview, TX 75605-2411 | 2007-05-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194353730 | Dusty Rae Hane | Nurse Practitioner | Diagnostic Clinic of Longview, 2901 N Fourth St, Longview, TX 75605 | 2020-03-30 |
| 1831720374 | Kaycee Whatley | Nurse Practitioner | 323 W Hawkins Parkway, Longview, TX 75605 | 2020-02-03 |
| 1245733492 | Somers Pediatrics | Pediatrics | 103 W. Loop 281, Suite 474, Longview, TX 75605 | 2018-03-14 |
| 1467838391 | Piney Woods Er II LLC | Clinic/Center | 120 East Loop 281, Longview, TX 75605 | 2015-08-03 |
| 1386023968 | Elizabeth Ann Heeb Tidwell | Obstetrics & Gynecology | 802 Medical Dr Ste 100, Longview, TX 75605 | 2015-05-28 |
| 1215353651 | Tracy Hicks | Nurse Practitioner | 102 Commander Dr Ste 9, Longview, TX 75605 | 2014-03-10 |
| 1073881280 | Deirdre Scotter | Specialist/Technologist | 201 E Tomlinson Pkwy, Longview, TX 75605 | 2011-12-02 |
| 1316230139 | Traditions Hospice of Longview, LLC | Hospice Care, Community Based | 4362 N Us Hwy 259, Suite B, Longview, TX 75605 | 2011-05-26 |
| 1184916769 | Telema Dikibujiri Nga | Pediatrics | Longview Regional Medical Center, 2901 North Fourth Street, Longview, TX 75605 | 2011-05-13 |
| 1902101108 | The Veta Lewis Behavioral Health Group | Counselor | 1800 S. Judson St., Suite 100, Longview, TX 75605 | 2011-01-19 |
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| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920247 | Lisa Kalynn Sanders | Nurse Practitioner | 2128 Page Creek Trl, Longview, TX 75601-0007 | 2020-10-20 |
| 1265030993 | Sarah Dawson | Nurse Practitioner | 2040 Eden Dr, Longview, TX 75601-3415 | 2020-10-14 |
| 1104455716 | Carol Henry | Nurse Practitioner | 287 E Cliffwood St, Longview, TX 75603-7556 | 2020-04-06 |
| 1831720374 | Kaycee Whatley | Nurse Practitioner | 323 W Hawkins Parkway, Longview, TX 75605 | 2020-02-03 |
| 1649821901 | Heather M Wilson | Nurse Practitioner | 2828 Bill Owens Pkwy Ste B, Longview, TX 75605-2102 | 2019-09-26 |
| 1942777826 | Cami Jo Tice-harouff | Nurse Practitioner | 16 Ramblewood Dr, Longview, TX 75605-3351 | 2018-10-29 |
| 1346778685 | Kyle Patrick Urbanek | Nurse Practitioner | 705 E Marshall Ave Ste 5000, Longview, TX 75601-5660 | 2017-05-31 |
| 1417481623 | Cody Castle | Nurse Practitioner | 1103 Eden Dr, Longview, TX 75605-3114 | 2017-04-13 |
| 1134570856 | Virginia Hardaway | Nurse Practitioner | 2953 Country Club Rd W, Longview, TX 75602-6861 | 2016-06-23 |
| 1275994824 | Alto Behavioral Health Services Pllc | Nurse Practitioner | 827 Lansing Switch Rd, Longview, TX 75602-7102 | 2016-03-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.