Provider Demographics
NPI:1033491295
Name:OLIVAREZ, LETICIA (ATP)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:
Last Name:OLIVAREZ
Suffix:
Gender:F
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E CEDAR AVE
Mailing Address - Street 2:STE A & B
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-8726
Mailing Address - Country:US
Mailing Address - Phone:956-631-6914
Mailing Address - Fax:956-631-6946
Practice Address - Street 1:501 E CEDAR AVE
Practice Address - Street 2:STE A & B
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8726
Practice Address - Country:US
Practice Address - Phone:956-631-6914
Practice Address - Fax:956-631-6946
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other