Healthcare Provider Details

I. General information

NPI: 1053318311
Provider Name (Legal Business Name): NOEL E OLIVEIRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 04/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5509 DOCTORS DR
EDINBURG TX
78539-5563
US

IV. Provider business mailing address

5111 N 10TH ST PMB 315
MCALLEN TX
78504-2835
US

V. Phone/Fax

Practice location:
  • Phone: 956-362-5525
  • Fax: 956-971-5527
Mailing address:
  • Phone: 956-362-5525
  • Fax: 956-971-5527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH6484
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberH6484
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: