Provider Demographics
NPI:1053655142
Name:OLOO, VIVIANFAITH (PA-C)
Entity Type:Individual
Prefix:
First Name:VIVIANFAITH
Middle Name:
Last Name:OLOO
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 679113
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-9113
Mailing Address - Country:US
Mailing Address - Phone:832-953-2280
Mailing Address - Fax:832-953-2829
Practice Address - Street 1:13406 MEDICAL COMPLEX DR STE 180
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-3339
Practice Address - Country:US
Practice Address - Phone:832-953-2280
Practice Address - Fax:832-953-2829
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2018-02-28
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant