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Individual
THOMAS JOHN OLIVERSON
Active
Individual
THOMAS JOHN OLIVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
L8152
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1628913
LA - MEDICAID
LA
05
—
169492902
—
TX
05
—
169492903
—
TX
01
—
8AW2335
BLUE CROSS BLUE SHIELD
TX
01
—
8B6004
OUT HARRIS - MEDICARE
TX
01
—
8K8602
BLUE CROSS
TX
01
—
P00102257
RAILROAD - MEDICARE
TX
Enumeration date
01/16/2007
Last updated
06/05/2018
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