Provider Demographics
NPI:1518066372
Name:OLIVER, GERMAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:GERMAN
Middle Name:A
Last Name:OLIVER
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:PO BOX 35629
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0629
Mailing Address - Country:US
Mailing Address - Phone:214-424-2213
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:2694 N GALLOWAY AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6312
Practice Address - Country:US
Practice Address - Phone:972-681-2226
Practice Address - Fax:972-681-7838
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4032207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S9977OtherBCBS
TX117301502Medicaid
TXH4032OtherMEDICAL LICENSE
TX8S9977OtherBCBS
TXH4032OtherMEDICAL LICENSE