Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 000816 | GA |
N | 213ES0131X | Foot Surgery | 1544 | TX |
NPI | 1154341477 |
---|---|
Provider Name | Luis Oliva |
First Address | El Paso, TX 79937-0593 |
Second Address | El Paso, TX 79930-4210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 21/09/2018 |