Edgardo Yabir Olivares, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

112354 Issued in TX

Practice address

4700 E Riverside Dr Apt 1418
Austin, TX 78741-4767

Phone

(832) 358-5500

NPI assigned

Sep 1, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1164036844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5818 BEVERLYHILL ST STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770576710",
            "telephone_number": "832-358-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 E RIVERSIDE DR APT 1418",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787414767",
            "telephone_number": "832-358-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVARES",
        "first_name": "EDGARDO",
        "middle_name": "YABIR",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "112354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Michelle Oler, MD, MPH
• Adam D Olesen, PHARMD
• Rosario Olguin-Aguirre, LPC-ASSOCIATE
• Alexandra Olguin, MS,RD,LD
• Alberto H Olivares, D.D.S.
• Katelyn Olivares
• Marc Olivares, MA, MS, LPC-S
• Roberto Rolando Olivares, R.PH.
• Kristen Marie Olivarez, LCDC
• Kristyn M Olivarez, PA-C

• Massage Therapist in Austin, TX
• Providers in Austin, TX by specialty
• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.