Rebecca Holm, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA03306 Issued in TX

Practice address

2222 Welborn St
Dallas, TX 75219-3924

Phone

(214) 559-7830

Fax

(214) 559-8383

NPI assigned

Apr 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rebecca Konen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1861615528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10011 WINDLEDGE DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752382148",
            "telephone_number": "979-733-2281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-7830",
            "fax_number": "214-559-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM",
        "first_name": "REBECCA",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA03306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "KONEN",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Holloway, PHARMD
• Kimberly Dawn Holloway, BSW
• Steven Blaine Holloway, MD
• Lara Kirstin Holly, D.M.D.
• Leah Holly, D.O.
• Aisha D Holman, LPC
• Bertha Lee Holmes-Price, LMSW
• Avery Madeline Holmes
• Cameron Matthew Holmes, MD
• Cara Pearson Holmes, PH.D.

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.