Healthcare Provider Details

I. General information

NPI: 1366159881
Provider Name (Legal Business Name): OYUKI MIWA SALDIVAR FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2022
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 GREENBRIAR STE 200
MIDLAND TX
79707-4653
US

IV. Provider business mailing address

4060 FAUDREE RD., SUITE 104A, #413
ODESSA TX
79765
US

V. Phone/Fax

Practice location:
  • Phone: 432-618-5215
  • Fax:
Mailing address:
  • Phone: 432-653-3106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number928098
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: