Provider Demographics
NPI:1861033417
Name:OLUWEK, JARED
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:OLUWEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WEST GRADUATE VILLAGE 208
Mailing Address - Street 2:1825 TEXAS TECH PARKWAY
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:WEST GRADUATE VILLAGE 208
Practice Address - Street 2:1825 TEXAS TECH PARKWAY
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79406
Practice Address - Country:US
Practice Address - Phone:239-249-0827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program