Organization
PROVIDENCE MEDICAL AND GERIATRIC ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLGA MARIA OLIVARES-HERRERA MD (PRESIDENT)
(956) 971-8800
Entity
Organization
Contact information
Practice address
110 E SAVANNAH AVE, BLDG C SUITE 103, MCALLEN, TX 78503-1241
(956) 971-8800
(956) 971-8804
Mailing address
PO BOX 306, MCALLEN, TX 78505-0306
(956) 971-8800
(956) 971-8804
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
M2431
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022NP
BCBS
TX
05
—
180576401
—
TX
Enumeration date
07/17/2007
Last updated
01/20/2020
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