Individual
DIANA P OLIVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 539-4764
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA13596
TX
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/17/2020
Last updated
01/29/2025
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