Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 18772 | TX |
N | 1223P0221X | Pediatric Dentist | 18772 | TX |
N | 1223P0221X | Pediatric Dentist | DE00010026 | WA |
NPI | 1972767176 |
---|---|
Provider Name | Dr. Alexander S Olea |
First Address | San Antonio, TX 78216-7850 |
Second Address | San Antonio, TX 78216-7850 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2008 |
Last Update Date | 14/02/2022 |