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General NPI Number Information
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NPI Number | 1780478313
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Entity Type | Organization
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Legal Business Name | OLIVIA WELLNESS CENTERS LLC
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 3127 MONTANA AVE
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City | EL PASO
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State | TX
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Zip | 79903-2502
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Country | US
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Telephone | 915-822-9995
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Fax |
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Provider Business Mailing Address
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Address Line | 3127 MONTANA AVE
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City | EL PASO
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State | TX
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Zip | 79903-2502
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Country | US
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Telephone | 915-822-9995
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. TEODORO HERRERA
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Credential | RN
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Telephone | 915-203-6371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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