Provider Demographics
NPI:1073654901
Name:DIONNE D OLIVER MD PA
Entity Type:Organization
Organization Name:DIONNE D OLIVER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DIONNE
Authorized Official - Middle Name:D
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-670-9200
Mailing Address - Street 1:610 STRICKLAND DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-4786
Mailing Address - Country:US
Mailing Address - Phone:409-670-9200
Mailing Address - Fax:409-670-9201
Practice Address - Street 1:610 STRICKLAND DR
Practice Address - Street 2:SUITE 280
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4786
Practice Address - Country:US
Practice Address - Phone:409-670-9200
Practice Address - Fax:409-670-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00210ZMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER