Provider Demographics
NPI:1184753444
Name:SAMUEL DURO OLOYO, M.D.,P.A.
Entity type:Organization
Organization Name:SAMUEL DURO OLOYO, M.D.,P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:OLOYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-854-7001
Mailing Address - Street 1:3912 SARATOGA BLVD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-5815
Mailing Address - Country:US
Mailing Address - Phone:361-854-7001
Mailing Address - Fax:361-855-8444
Practice Address - Street 1:3912 SARATOGA BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-5815
Practice Address - Country:US
Practice Address - Phone:361-854-7001
Practice Address - Fax:361-855-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7588302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159697501Medicaid
TXDG9015OtherMEDICARE RAILROAD
TX159697501Medicaid