Derrick Holt

Individual provider Active NPI Physical Therapy Assistant · Bee Caves, TX

NPI 1720675705 · NPPES record last updated Dec 24, 2020

Key facts

NPI
1720675705
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2145541 (TX)
Practice address
14058 Bee Cave Pkwy
Bee Caves, TX 78738-7071
Phone
(512) 872-8170
NPI assigned
Dec 24, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2145541TXMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2145541 TX Yes

Addresses

Primary practice location

14058 Bee Cave Pkwy
Bee Caves, TX 78738-7071

Mailing address

9101 La Cresada Dr Apt 1823
Austin, TX 78749-4041
Phone (828) 337-1469

Other providers in Bee Caves, TX

All providers in Bee Caves, TX · Physical Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.