Provider Demographics
NPI:1437801453
Name:OLIVAS, BEATRIZ ADRIANA
Entity Type:Individual
Prefix:MRS
First Name:BEATRIZ
Middle Name:ADRIANA
Last Name:OLIVAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BEATRIZ
Other - Middle Name:ADRIANA
Other - Last Name:PORRAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:852 CARDAN PL
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-2426
Mailing Address - Country:US
Mailing Address - Phone:405-596-6301
Mailing Address - Fax:
Practice Address - Street 1:852 CARDAN PL
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-2426
Practice Address - Country:US
Practice Address - Phone:405-596-6301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator