Provider Demographics
NPI:1093476251
Name:ELORREAGA, OLHA (PA-C)
Entity type:Individual
Prefix:
First Name:OLHA
Middle Name:
Last Name:ELORREAGA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:OLHA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 35232
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0630
Mailing Address - Country:US
Mailing Address - Phone:817-375-5200
Mailing Address - Fax:
Practice Address - Street 1:2801 E BROAD ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-9128
Practice Address - Country:US
Practice Address - Phone:817-375-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-09
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA15394OtherTEXAS MEDICAL BOARD