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NPI Code Detail

MEDICARE: TREVELYN OLIVE MD

MEDICARE:   TREVELYN  OLIVE  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
1207V00000XObstetrics & Gynecology PhysicianM1992TX

Other Identifiers

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

General Provider Information

NPI Number : 1871581678
Entity Type Code : Individual
Provider Name (Legal Business Name) : TREVELYN OLIVE MD
Provider Business Mailing Address
First Line : 515 W MAYFIELD RD
Second Line : STE 200
City : ARLINGTON
State : TX
Zip : 76014-2083
Country : US
Telephone Number : 817-468-4689
Fax Number : 817-465-7872
Provider Business Practice Location Address
First Line : 515 W MAYFIELD RD
Second Line : STE 200
City : ARLINGTON
State : TX
Zip : 76014-2083
Country : US
Telephone Number : 817-468-4689
Fax Number : 817-465-7872
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2005
Last Update Date : 08/09/2010

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Directions to “ TREVELYN OLIVE MD” Practice Location

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