Healthcare Provider Details

I. General information

NPI: 1487525101
Provider Name (Legal Business Name): ANA LAURA OLVERA-TORRES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 MEDICAL PARK LN STE A
HUNTSVILLE TX
77340-4975
US

IV. Provider business mailing address

2420 FM 1725 RD
WILLIS TX
77378-2360
US

V. Phone/Fax

Practice location:
  • Phone: 936-500-9500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1212966
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: