Healthcare Provider Details

I. General information

NPI: 1851201370
Provider Name (Legal Business Name): ANGELA OVIEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 H G MOSLEY PKWY
LONGVIEW TX
75604-3663
US

IV. Provider business mailing address

8646 GUION RD
INDIANAPOLIS IN
46268-3011
US

V. Phone/Fax

Practice location:
  • Phone: 903-353-9247
  • Fax: 317-334-7336
Mailing address:
  • Phone: 317-334-7331
  • Fax: 317-337-7336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2846166
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: