MEDICARE: FLORESTELLA OLIVAREZ RUIZ RUPTIER D.D.S.

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	122300000X	Dentist	32242	TX

General Provider Information

NPI Number	:	1922553932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLORESTELLA OLIVAREZ RUIZ RUPTIER D.D.S.

Provider Business Mailing Address
First Line	:	1106 STEUBING OAKS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4221
Country	:	US
Telephone Number	:	210-441-9056
Fax Number	:

Provider Business Practice Location Address
First Line	:	1106 STEUBING OAKS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4221
Country	:	US
Telephone Number	:	210-441-9056
Fax Number	:

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

Provider Enumeration Date	:	08/19/2016
Last Update Date	:	04/26/2019

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