Individual
JENNIFER TEJADA OLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2900 E 29TH ST, BRYAN, TX 77802-2622
(979) 776-8440
Mailing address
2900 E 29TH ST STE 100, BRYAN, TX 77802-2623
(979) 776-0884
(877) 601-5854
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
47152
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1F2393
MEDICARE
TX
05
—
414421401
—
TX
Enumeration date
04/30/2015
Last updated
10/11/2022
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