MEDICARE: DR. BERNARDO OLAYA M.D. P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VX0000X	Obstetrics Physician	G8740	TX
2	207V00000X	Obstetrics & Gynecology Physician	G8740	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8AJ784	OTHER	TX	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1033169818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BERNARDO OLAYA M.D. P.A.

Provider Business Mailing Address
First Line	:	PO BOX 4106
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-0106
Country	:	US
Telephone Number	:	940-766-6500
Fax Number	:	940-766-6506

Provider Business Practice Location Address
First Line	:	2211 MIDWESTERN PKWY
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2300
Country	:	US
Telephone Number	:	940-766-6500
Fax Number	:	940-766-6506

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	05/18/2022

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1134203813 — BERNARDO OLAYA M.D. PA
Practice Location Address:

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Practice Fax: 940-766-6506

Directions to “ DR. BERNARDO OLAYA M.D. P.A.” Practice Location

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