Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1766 | TX |
Y | 222Z00000X | Podiatrist | 1766 | TX |
NPI | 1053368332 |
---|---|
Provider Name | Dr. Raymond J Oliviero |
First Address | Spring Branch, TX 78070 |
Second Address | San Antonio, TX 78258-4113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 09/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
180589701 | (05) | TX |