Provider Demographics
NPI:1265439541
Name:OLIVER, DENNIS CAREY (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:CAREY
Last Name:OLIVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9969 FREDERICKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4106
Mailing Address - Country:US
Mailing Address - Phone:210-690-2273
Mailing Address - Fax:210-581-8209
Practice Address - Street 1:9969 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-4106
Practice Address - Country:US
Practice Address - Phone:210-690-2273
Practice Address - Fax:210-581-8209
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2011-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9697207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1060212-02Medicaid
2044226OtherAETNA
85274YOtherBCBS
384845OtherONE HEALTH
9770090003OtherCIGNA HMO
16167-0011OtherPACIFICARE
737806OtherHUMANA GOLD
3391163OtherBLUE LINK
9770090002OtherCIGNA POS
737806OtherHUMANA GOLD
F91163Medicare UPIN