Juvenal Olivares, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2168648 Issued in TX

Practice address

1514 N Zaragoza Rd Ste B4
El Paso, TX 79936-8041

Phone

(915) 257-5782

NPI assigned

May 5, 2022

Sex

Male

Sole proprietor

No

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Early Bird Pediatric Therapy Clinic, Inc

  • Rehabilitation Clinic/Center
  • El Paso, TX
  • NPI 1639538077
  NPD

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1194461913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11582 CHAPLIN CT",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799364941",
            "telephone_number": "915-471-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 N ZARAGOZA RD STE B4",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799368041",
            "telephone_number": "915-257-5782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVARES",
        "first_name": "JUVENAL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2168648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sebastian Olguin
• Luis Oliva, D.P.M.
• Frankie Olivar, SLP
• Luis Fernando Olivares Rodriguez, SA-C
• Elizabeth Olivares
• Orlando Olivares
• Robert A Olivares Jr., MD
• Robert A Olivares Sr., MD
• Vanessa Stephanie Olivares, AU.D
• Gabino Olivarez, A.T.C., L.A.T

• Physical Therapy Assistant in El Paso, TX
• Providers in El Paso, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.