Individual
ROBERT A OLIVARES SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1801 N OREGON ST, EL PASO, TX 79902-3524
(915) 521-1200
(866) 862-5432
Mailing address
PO BOX 203629, DALLAS, TX 75320-0001
(915) 533-3474
(915) 544-5037
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G2446
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
G2446
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120287102
—
TX
05
—
120287103
—
TX
05
—
V0112
—
NM
Enumeration date
10/10/2005
Last updated
09/27/2013
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