Individual
DR. JAIRO RAFAEL OLIVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 CLARA BARTON BLVD, SUITE 250, GARLAND, TX 75042-5703
(972) 272-3417
(972) 272-2425
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
J9250
TX
207RX0202X
Medical Oncology Physician
J9250
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135860810
—
TX
05
—
135860811
—
TX
01
—
8S7053
BLUE CROSS OF TEXAS
TX
Enumeration date
06/02/2006
Last updated
06/07/2011
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