Basic Information
Provider Information
NPI: 1912263724
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SIROPAIDES
FirstName: CAITLIN
MiddleName: HOLT
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HOLT
OtherFirstName: CAITLIN
OtherMiddleName: ELIZABETH
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: D.O.
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 845347
Address2:  
City: DALLAS
State: TX
PostalCode: 752845347
CountryCode: US
TelephoneNumber: 2146458600
FaxNumber: 2146450078
Practice Location
Address1: 5323 HARRY HINES BLVD
Address2:  
City: DALLAS
State: TX
PostalCode: 753907201
CountryCode: US
TelephoneNumber: 2146458600
FaxNumber: 2146450078
Other Information
ProviderEnumerationDate: 04/05/2012
LastUpdateDate: 10/31/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0002XQ7966TXY Allopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine

No ID Information.


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