Provider Demographics
NPI:1437193836
Name:OLIVARES-HERRERA, OLGA MARIA (MD)
Entity Type:Individual
Prefix:MRS
First Name:OLGA
Middle Name:MARIA
Last Name:OLIVARES-HERRERA
Suffix:
Gender:F
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:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78505-0306
Mailing Address - Country:US
Mailing Address - Phone:956-971-8800
Mailing Address - Fax:956-971-8804
Practice Address - Street 1:110 E SAVANNAH AVE
Practice Address - Street 2:BLDG C SUITE 103
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1241
Practice Address - Country:US
Practice Address - Phone:956-971-8800
Practice Address - Fax:956-971-8804
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2431207Q00000X, 207QG0300X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8V4980OtherBC&BS INDIVIDUAL PIN
TX180578001Medicaid
TX8V4980OtherBC&BS INDIVIDUAL PIN
TX269808YKSJMedicare PIN