Individual
MR. MICHAEL PAUL OLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HT,OST,C-PED,PMAC
Contact information
Practice address
3600 MEMORIAL BLVD # 11C, KERRVILLE, TX 78028-5768
(830) 792-2660
Mailing address
404 CIRCLE AVE, KERRVILLE, TX 78028-4122
(830) 896-0442
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
211D00000X
Podiatric Assistant
—
—
246Y00000X
Health Information Specialist/Technologist
—
—
246ZS0410X
Surgical Technologist
Primary
—
—
247200000X
Other Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2348
CERTIFIED PEDORTHIST
TX
Enumeration date
10/27/2006
Last updated
10/31/2007
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