Provider Demographics
NPI:1053318311
Name:OLIVEIRA, NOEL E (MD)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:E
Last Name:OLIVEIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5111 N 10TH ST PMB 315
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2835
Mailing Address - Country:US
Mailing Address - Phone:956-362-5525
Mailing Address - Fax:956-971-5527
Practice Address - Street 1:5509 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5563
Practice Address - Country:US
Practice Address - Phone:956-362-5525
Practice Address - Fax:956-971-5527
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6484207Q00000X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080120248OtherRAILROAD MEDICARE
TX5275483OtherAETNA
TX00J68ZOtherBCBS
TX135588506Medicaid
TX080120248OtherRAILROAD MEDICARE
00J68ZMedicare ID - Type Unspecified