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NPI Code Detail

MEDICARE: ROBERT A OLIVARES SR. MD

MEDICARE: ROBERT A OLIVARES SR. MD
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
1207LP2900XPain Medicine (Anesthesiology) PhysicianG2446TX
2207L00000XAnesthesiology PhysicianG2446TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811985252
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT A OLIVARES SR. MD
Provider Business Mailing Address
First Line : PO BOX 203629
Second Line :
City : DALLAS
State : TX
Zip : 75320-0001
Country : US
Telephone Number : 915-533-3474
Fax Number : 915-544-5037
Provider Business Practice Location Address
First Line : 1801 N OREGON ST
Second Line :
City : EL PASO
State : TX
Zip : 79902-3524
Country : US
Telephone Number : 915-521-1200
Fax Number : 866-862-5432
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2005
Last Update Date : 09/27/2013

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Directions to “ ROBERT A OLIVARES SR. MD” Practice Location

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