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General NPI Number Information
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NPI Number | 1609542026
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Entity Type | Individual
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Provider Name | VANESSA STEPHANIE OLIVARES AU.D
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Gender | Female
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 9830 GATEWAY BLVD N
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City | EL PASO
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State | TX
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Zip | 79924-4410
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Country | US
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Telephone | 915-215-6891
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Fax | 915-215-6892
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Provider Business Mailing Address
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Address Line | 5130 GATEWAY BLVD E
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City | EL PASO
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State | TX
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Zip | 79905-1608
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Country | US
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Telephone | 915-215-4480
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Fax | 915-215-5386
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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 | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 81604
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 81604
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License Number State | TX
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