Provider Demographics
NPI:1023106101
Name:OLIVARES, ADRIAN (DC)
Entity type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:
Last Name:OLIVARES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 INLAND LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3857
Mailing Address - Country:US
Mailing Address - Phone:214-325-5037
Mailing Address - Fax:214-943-5110
Practice Address - Street 1:6675 MEDITERRANEAN DR
Practice Address - Street 2:SUITE 404
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5573
Practice Address - Country:US
Practice Address - Phone:214-838-8434
Practice Address - Fax:888-507-6119
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203979988Medicare UPIN