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NPI Code Detail

MEDICARE: TINA OLIVER DPM

MEDICARE:   TINA  OLIVER  DPM
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
1213E00000XPodiatrist1071TX

General Provider Information

NPI Number : 1467470245
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA OLIVER DPM
Provider Business Mailing Address
First Line : 2309 BLODGETT ST
Second Line :
City : HOUSTON
State : TX
Zip : 77004-5254
Country : US
Telephone Number : 713-661-3393
Fax Number : 713-661-3394
Provider Business Practice Location Address
First Line : 2309 BLODGETT ST
Second Line :
City : HOUSTON
State : TX
Zip : 77004-5254
Country : US
Telephone Number : 713-661-3393
Fax Number : 713-661-3394
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 07/08/2007

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Directions to “ TINA OLIVER DPM” Practice Location

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