Provider Demographics
NPI:1053718296
Name:HOLMES, ISREAL CORNELIUS (STAR OF DAVID)
Entity type:Individual
Prefix:
First Name:ISREAL
Middle Name:CORNELIUS
Last Name:HOLMES
Suffix:
Gender:M
Credentials:STAR OF DAVID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3122 SPRINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5101
Mailing Address - Country:US
Mailing Address - Phone:832-275-2686
Mailing Address - Fax:866-292-3523
Practice Address - Street 1:3122 SPRINGDALE DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5101
Practice Address - Country:US
Practice Address - Phone:832-275-2686
Practice Address - Fax:866-292-3523
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-03
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No172A00000XOther Service ProvidersDriver
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker