Provider Demographics
NPI:1578646428
Name:HOLT, JANIE ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:JANIE
Middle Name:ELIZABETH
Last Name:HOLT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 S CLAY ST
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-5752
Mailing Address - Country:US
Mailing Address - Phone:972-875-4200
Mailing Address - Fax:972-875-4342
Practice Address - Street 1:911 S CLAY ST
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-5752
Practice Address - Country:US
Practice Address - Phone:972-875-4200
Practice Address - Fax:972-875-4342
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7429208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH7429OtherSTATE LICENSE
TX8P4090OtherBLUE CROSS BLUE SHIELD
TX8P4090OtherBLUE CROSS BLUE SHIELD