MEDICARE: MR. DONALD R. OLIVER PHYSICAL THERAPIST

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	225100000X	Physical Therapist	1132884	TX

General Provider Information

NPI Number	:	1528083136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD R. OLIVER PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	6110 SYLLING DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-6128
Country	:	US
Telephone Number	:	361-815-1302
Fax Number	:	361-232-4964

Provider Business Practice Location Address
First Line	:	1028 S 14TH ST
Second Line	:
City	:	KINGSVILLE
State	:	TX
Zip	:	78363-6422
Country	:	US
Telephone Number	:	361-815-1302
Fax Number	:	361-232-4964

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	06/28/2013

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Directions to “ MR. DONALD R. OLIVER PHYSICAL THERAPIST” Practice Location

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