Holloway Eyecare PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

030365 Issued in MI

Legal business name

HOLLOWAY EYECARE PC

Practice address

20905 Greenfield Rd Ste 301
Southfield, MI 48075-5347

Phone

(248) 569-5577

Fax

(248) 569-6211

NPI assigned

Sep 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Deirdre C Holloway, MD

Title

President

Phone

(248) 569-5577

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1548368954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD STE 301",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755347",
            "telephone_number": "248-569-5577",
            "fax_number": "248-569-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD STE 301",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755347",
            "telephone_number": "248-569-5577",
            "fax_number": "248-569-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLOWAY EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY",
        "authorized_official_first_name": "DEIRDRE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-569-5577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "030365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104924743",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1806355592",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Holdwick
• Debra Hollander, MD
• Javion L Hollins
• Lia Marie Hollis, LMSW, LCDC-I
• Teigon Hollis
• Deirdre C Holloway, M.D.
• Erving Holloway
• Kevin W Holloway, PHARMD
• Melvin Laverne Hollowell, MD
• Hollywood Hosiery LLC

• Optometrist in Southfield, MI
• Providers in Southfield, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.