Provider Demographics
NPI:1538750021
Name:HOLLEY, DAVID ZANE (DPT)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ZANE
Last Name:HOLLEY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 FORT WORTH HWY STE 1200
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-4570
Mailing Address - Country:US
Mailing Address - Phone:817-594-9200
Mailing Address - Fax:
Practice Address - Street 1:1115 FORT WORTH HWY STE 1200
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-4570
Practice Address - Country:US
Practice Address - Phone:817-594-9200
Practice Address - Fax:817-594-9202
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1341318OtherPT LICENSE