Individual
OLIVIA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6411 FANNIN ST, HOUSTON, TX 77030-1501
(713) 704-4000
(713) 704-5269
Mailing address
6411 FANNIN ST, HOUSTON, TX 77030-1501
(713) 704-4000
(713) 704-5269
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
T3693
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
T3693
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2018
Last updated
04/29/2024
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