Provider Demographics
NPI:1972682136
Name:OLSSON, SCOTT E (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:E
Last Name:OLSSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:21216 NORTHWEST FWY
Mailing Address - Street 2:SUITE 680
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4695
Mailing Address - Country:US
Mailing Address - Phone:713-467-5111
Mailing Address - Fax:713-467-5198
Practice Address - Street 1:21216 NORTHWEST FWY
Practice Address - Street 2:SUITE 680
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4695
Practice Address - Country:US
Practice Address - Phone:713-467-5111
Practice Address - Fax:713-467-5198
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2011-11-22
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Provider Licenses
StateLicense IDTaxonomies
TXL8153208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1700346-01Medicaid
TX8P8350OtherBLUE CROSS
TXH15600Medicare UPIN
TX8P8350OtherBLUE CROSS