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General NPI Number Information
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NPI Number | 1184406803
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Entity Type | Organization
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Legal Business Name | OLIVE TREE HEALTH PLLC
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Dates
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Enumeration Date | 10/17/2023
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 21750 HARDY OAK BLVD. STE. 104
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City | SAN ANTONIO
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State | TX
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Zip | 78258
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Country | US
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Telephone | 210-347-2367
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Fax |
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Provider Business Mailing Address
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Address Line | 2186 JACKSON KELLER RD STE 1204
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City | SAN ANTONIO
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State | TX
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Zip | 78213-2723
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA URTEAGA
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Credential | MD
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Telephone | 210-347-2367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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