KATRINA JACKSON HOLLEY (NPI# 1427594381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427594381 |
| Entity Type | Individual |
| Full Name | KATRINA JACKSON HOLLEY |
| Other Name | KATRINA JADE JACKSON |
| Credential | PA |
| Practice Address |
1604 Hospital Pkwy Ste 501 Bedford TX 76022-6932 |
| Practice Telephone | 8176842700 |
| Practice Fax Number | 8176842709 |
| Mailing Telephone | 8176842700 |
| Mailing Fax Number | 8176842709 |
| Enumeration Date | 2017-01-16 |
| Last Update Date | 2018-03-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA11078 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1604 HOSPITAL PKWY STE 501 |
| City | BEDFORD |
| State | TX |
| Zip Code | 76022-6932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831198720 | Jerry Thomas Light Jr. | Surgery | 1604 Hospital Pkwy Ste 501, Bedford, TX 76022-6932 | 2005-07-21 |
| 1750791240 | Nathaniel Grey Jones | Physician Assistant | 1604 Hospital Pkwy Ste 501, Bedford, TX 76022-6932 | 2014-05-06 |
| 1437492345 | Collin D Gandillon | Surgery | 1604 Hospital Pkwy Ste 501, Bedford, TX 76022-6932 | 2013-03-28 |
| 1174773873 | Babafemi Babawande Pratt | Surgery | 1604 Hospital Pkwy Ste 501, Bedford, TX 76022-6932 | 2008-09-30 |
| 1497920953 | Sajid Hussain Shah | Surgery | 1604 Hospital Pkwy Ste 501, Bedford, TX 76022-6932 | 2008-04-25 |
| 1578751095 | Heb Neurosurgery Pa | Specialist | 1604 Hospital Pkwy Ste 501, Bedford, TX 76022-6932 | 2007-10-10 |
| 1609929538 | Madhavi Meka | Surgery | 1604 Hospital Pkwy Ste 501, Bedford, TX 76022-6932 | 2007-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376155754 | Jacquelyn H Holloway | Registered Nurse | 820 Uptown Blvd, Bedrord, TX 76022 | 2020-08-18 |
| 1861972556 | Red Diamond Medical Group Pllc | Internal Medicine | 2700 Tibbets Dr # 301, Bedford, TX 76022 | 2018-08-21 |
| 1649761958 | Florine Karimi Mati | Behavioral Analyst | 1413 Tennis Dr, Bedford, TX 76022 | 2018-05-22 |
| 1760836704 | Healing Hands Senior Care Service | Technician | 1152 High Point Rd., Bedford, TX 76022 | 2016-04-15 |
| 1972965283 | Emily Vandoren | Physical Therapist | 1705 Forest Ridge Drive, Bedford, TX 76022 | 2016-03-25 |
| 1396123949 | Decorla Holmes | Adult Companion | 1152 Highpoint Rd., Bedford, TX 76022 | 2015-05-15 |
| 1629409198 | Susan Yvonne Pelletier | Durable Medical Equipment & Medical Supplies | 1600 Central Drive, Suite 157, Bedford, TX 76022 | 2013-12-09 |
| 1649565953 | Alisa Thamwiwat | Internal Medicine | 1604 Hospital Pkwy Ste 301, Bedford, TX 76022 | 2011-06-15 |
| 1528227576 | Ft. Worth Home Care Inc | Home Health | 1600 Airport Freeway, Suite 503, Bedford, TX 76022 | 2008-06-05 |
| 1225242886 | Bedford Family Medicine, Pa | Family Medicine | 1701 Forest Ridge Dr., Bedford, TX 76022 | 2007-05-10 |
| Find all providers in zip 76022 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992281679 | Surgical Masters First Assistants | Physician Assistant | 2708 Maple Brook Ct, Bedford, TX 76021-7212 | 2018-07-16 |
| 1821338344 | Matthew E. Porter | Physician Assistant | 4 Hawthorne Dr, Bedford, NH 03110-6983 | 2013-02-20 |
| 1730294828 | Carl Travis Palmer | Physician Assistant | 4 Hawthorne Dr, Bedford, NH 03110-6912 | 2006-08-20 |
| 1356456263 | Brian Edward Snow | Physician Assistant | 4 Hawthorne Dr, Bedford, NH 03110-6912 | 2006-08-20 |
| 1699784314 | Dovie Mcvean | Physician Assistant | 2008 L Don Dodson Dr, Suite 110, Bedford, TX 76021-5788 | 2006-08-05 |
| 1841210804 | William J White | Physician Assistant | 1604 Hospital Pkwy, Suite 407, Bedford, TX 76022-6986 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133340 | Mark Alan Williams | Physician Assistant | 4814 Lake Livingston Dr, Corpus Christi, TX 78413-5139 | 2020-10-28 |
| 1669081238 | Manuel V Leyva | Physician Assistant | 8407 Sunset Loch Dr, Spring, TX 77379-5121 | 2020-07-29 |
| 1194342212 | Sean Robert Jamieson | Physician Assistant | 2700 E Broad St Ste 200, Mansfield, TX 76063-5899 | 2020-07-06 |
| 1588284194 | Hill Country Surgical Management, Inc | Physician Assistant | 10454 Tippecanoe, San Antonio, TX 78245-3128 | 2020-04-23 |
| 1407475585 | Serenity Surgical Services | Physician Assistant | 3260 Springbok Cir, Frisco, TX 75034-3671 | 2020-04-09 |
| 1720610470 | Surgical Assistants of South Texas | Physician Assistant | 3414 Highway 146 S, La Porte, TX 77571-7400 | 2020-02-11 |
| 1710524103 | R & H Surgical Services, LLC | Physician Assistant | 14507 Parkesgate Dr, Houston, TX 77083-5792 | 2019-12-04 |
| 1639711195 | Landry & Kiejna Surgical Assisting | Physician Assistant | 1120 Business Center Dr Ste 110, Houston, TX 77043-2735 | 2019-10-16 |
| 1912558693 | Chandrant Akshar Pa | Physician Assistant | 400 W Arbrook Blvd Ste 230, Arlington, TX 76014-3174 | 2019-09-24 |
| 1700435831 | Christina A Vogel-rosbrook | Physician Assistant | 4330 Medical Drive, Suite 120, San Antonio, TX 78229-3353 | 2019-09-11 |
| Find all providers with the same taxonomy | ||||
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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.