Provider Demographics
NPI:1548098817
Name:HOLST CHAIRES, JAN CHRISTIAN (SLP INTERN)
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:CHRISTIAN
Last Name:HOLST CHAIRES
Suffix:
Gender:M
Credentials:SLP INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 W KOENIG LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-1415
Mailing Address - Country:US
Mailing Address - Phone:512-480-9573
Mailing Address - Fax:
Practice Address - Street 1:1505 W KOENIG LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-1415
Practice Address - Country:US
Practice Address - Phone:512-480-9573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist