MEDICARE: BERNARDO OLAYA M.D. PA

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	207V00000X	Obstetrics & Gynecology Physician

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	B8740	OTHER	TX	TEXAS LICENSE
3	0046MB	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1134203813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERNARDO OLAYA M.D. PA

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 STE 3
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	:	DOCTOR
Name	:	DR. BERNARDO OLAYA
Credential	:	M.D. PA
Telephone Number	:	940-766-6500

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	03/07/2023

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