NPIMap

Organization Active NPI

Michael a Holy a Professional Medical Corporation

Doing business as Michael a Holy MD

  • Ophthalmology Physician
  • Shreveport, LA
National Provider Identifier
1790726693
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
03517R Issued in LA
Legal business name
MICHAEL A HOLY A PROFESSIONAL MEDICAL CORPORATION
Doing business as
Michael a Holy MD
Practice address
1801 Fairfield Ave
Suite 101
Shreveport, LA 71101-4443
Phone
(318) 424-1617
Fax
(318) 424-1610
NPI assigned
Jun 9, 2006
Last updated
Feb 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Authorized official

Name
Michael Adrian Holy, M.D.NPI 1932105483
Title
President
Phone
(318) 424-1617

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 03517R LA Primary

Addresses

Primary practice location

1801 Fairfield Ave
Suite 101
Shreveport, LA 71101-4443

Mailing address

1801 Fairfield Ave
Suite 101
Shreveport, LA 71101-4443
Phone (318) 424-1617

Other names 1

  • MICHAEL A HOLY MD Doing business as

National Provider Directory

National Provider Directory

Locations

1801 Fairfield Ave
Ste 101
Shreveport, LA 71101
Phone (318) 424-1617

105 Cottage Rd
Carthage, TX 75633
Phone (800) 730-4915

702 Louisiana St
Center, TX 75935
Phone (409) 598-8501

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1790726693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 FAIRFIELD AVE",
            "address_2": "SUITE 101",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014443",
            "telephone_number": "318-424-1617",
            "fax_number": "318-424-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 FAIRFIELD AVE",
            "address_2": "SUITE 101",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014443",
            "telephone_number": "318-424-1617",
            "fax_number": "318-424-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A HOLY A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "HOLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ADRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-424-1617",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "03517R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICHAEL A HOLY MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; 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.