Individual
DR. EDITH JENISSA OLIVERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2410 E RIVERSIDE DR STE G3, AUSTIN, TX 78741-3053
(512) 448-3778
(512) 448-3776
Mailing address
2410 E RIVERSIDE DR STE G3, AUSTIN, TX 78741-3053
(512) 448-3778
(512) 448-3776
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L4596
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153715105
—
TX
05
—
153715107
—
TX
05
—
155187102
—
TX
Enumeration date
12/18/2006
Last updated
06/30/2008
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