Individual provider Active NPI

Olivia Green

  • Student in an Organized Health Care Education/Training Program
  • Conroe, TX
National Provider Identifier
1104629708
Registry record updated Mar 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2477 FM 1488 Rd Apt 734
Conroe, TX 77384-4955
Phone
(512) 825-6851
NPI assigned
Mar 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2477 FM 1488 Rd Apt 734
Conroe, TX 77384-4955

Mailing address

2477 FM 1488 Rd Apt 734
Conroe, TX 77384-4955
Phone (512) 825-6851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1104629708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2477 FM 1488 RD APT 734",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773844955",
            "telephone_number": "512-825-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2477 FM 1488 RD APT 734",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773844955",
            "telephone_number": "512-825-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "OLIVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-29",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.