Healthcare Provider Details

I. General information

NPI: 1619669496
Provider Name (Legal Business Name): LINDSEY ROSE OLEARY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 FANNIN ST
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

2630 BISSONNET ST APT 2405
HOUSTON TX
77005-2373
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-7237
  • Fax: 713-486-0971
Mailing address:
  • Phone: 619-787-7104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: