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OLIVER PRESTON COPELAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1400 HWY 59 BYPASS, WHARTON, TX 77488
(713) 481-3533
(713) 432-0221
Mailing address
PO BOX 421209, HOUSTON, TX 77242-1209

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D6562
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10019839
AMERIGROUP
TX
05
135670102
TX
05
135670106
TX
05
135670109
TX
01
300015119
RAILROAD MEDICARE
TX
01
300079682
TRAVELERS MEDICARE
TX
01
81R652
BCBS
TX
01
82W999
BCBS-STMC
TX
01
8DE523
BC/BS #
TX
01
MDD6562TX
WORKER'S COMP
TX
Enumeration date
06/16/2005
Last updated
10/22/2012
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