MEDICARE: DR. RODOLFO JOSE OVIEDO MD, FACS, FASMBS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	Q8318	TX

General Provider Information

NPI Number	:	1376795955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODOLFO JOSE OVIEDO MD, FACS, FASMBS

Provider Business Mailing Address
First Line	:	4848 NE STALLINGS DR STE 201
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1266
Country	:	US
Telephone Number	:	936-221-5560
Fax Number	:	936-221-5710

Provider Business Practice Location Address
First Line	:	4848 NE STALLINGS DR STE 201
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1266
Country	:	US
Telephone Number	:	936-221-5560
Fax Number	:	936-221-5710

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2008
Last Update Date	:	11/12/2025

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