Provider Demographics
NPI:1457989238
Name:HOLT, JONATHAN LYLE (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:LYLE
Last Name:HOLT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:101 W LOUIS HENNA BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-1203
Mailing Address - Country:US
Mailing Address - Phone:512-244-4272
Mailing Address - Fax:512-593-4444
Practice Address - Street 1:3500 HILLCREST DR STE 1
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-3144
Practice Address - Country:US
Practice Address - Phone:254-741-6641
Practice Address - Fax:254-537-4693
Is Sole Proprietor?:No
Enumeration Date:2020-03-29
Last Update Date:2025-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV256742081P2900X
TXV82842081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine