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General NPI Number Information
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NPI Number | 1467567933
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Entity Type | Individual
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Provider Name | LARRY D OLIVER MD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 3302 W GOLF COURSE RD SUITE 100
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City | MIDLAND
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State | TX
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Zip | 79703-5110
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Country | US
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Telephone | 432-522-2304
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Fax | 432-522-2307
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Provider Business Mailing Address
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Address Line | PO BOX 28007
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City | PORTLAND
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State | OR
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Zip | 97228-8007
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Country | US
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Telephone | 844-540-8736
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Fax | 602-798-8267
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | F1867
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | F1867
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License Number State | TX
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