Nancy Elaine Holcek, PA
Individual provider Active NPI Physician Assistant · Canton, TX
NPI 1659345767 · NPPES record last updated Jun 20, 2019
Key facts
- NPI
- 1659345767
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA02007 (TX)
- Practice address
- 18780 Interstate 20
Canton, TX 75103-3593 - Phone
- (903) 567-4841
- NPI assigned
- Feb 15, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Christus Trinity Clinic Texas
Practice addresses (Care Compare)
18780 Interstate 20
Canton, TX 75103-3593
Phone (903) 567-4841
620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900
630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560
Hospital & facility affiliations
- Vitalcaring Group
- Christus Homecare
- Christus Mother Frances Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080527000447 | TX | Practitioner - Physician Assistant | 1658440003 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA02007 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christus Trinity Clinic Texas | Current |
Accepting new patients | |
| Christus Trinity Clinic Texas | Current |
Accepting new patients | |
| Trinity Clinic | Past | Accepting new patients |
Locations
2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500
3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018
Interoperability endpoints
- nholcek6260@christushealth.direct-ci.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA02007 | TX | Yes |
Addresses
Primary practice location
18780 Interstate 20
Canton, TX 75103-3593
Mailing address
PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6450
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P02220455 | Other | TX | MEDICARE RAIL ROAD |
| 201468002 | Medicaid | TX |
Other names
- Nancy Elaine McMillan
Other providers in Canton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.