Provider Demographics
NPI:1821839374
Name:OLEKSYUK, OLENA V
Entity type:Individual
Prefix:
First Name:OLENA
Middle Name:V
Last Name:OLEKSYUK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25127 W TARA PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-1619
Mailing Address - Country:US
Mailing Address - Phone:773-971-4114
Mailing Address - Fax:
Practice Address - Street 1:25127 W TARA PLANTATION DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-1619
Practice Address - Country:US
Practice Address - Phone:773-971-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT137548225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist