Individual provider Active NPI

Dominique Lizette Olivarez, AUD

  • Audiologist
  • Edinburg, TX
National Provider Identifier
1689127995
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
80750 Issued in TX
Practice address
2821 Michaelangelo Dr
Ste303
Edinburg, TX 78539-1404
Phone
(956) 362-2490
Fax
(956) 362-2493
NPI assigned
Aug 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 80750 TX Primary

Addresses

Primary practice location

2821 Michaelangelo Dr
Ste303
Edinburg, TX 78539-1404

Mailing address

PO Box 749
Pharr, TX 78577-1614
Phone (956) 362-2171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161019002990 TX Practitioner - Qualified Audiologist 1658669932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marquardt Audiology and Hearing AIDS PLLCGroup PAC ID 3971751009, 8 clinicians

Practice addresses (Care Compare)

11439 Spring Cypress Rd
Unit B
Tomball, TX 77377-6513
Phone (936) 273-4437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Marquardt Audiology & Hearing AIDS PLLC Audiologist CurrentSince May 29, 2018 Accepting new patients

Locations

1020 Riverwood Ct
Ste 115
Conroe, TX 77304
Phone (936) 273-4437

9533 Huffmeister Rd
#B
Houston, TX 77095
Phone (281) 763-7960

17350 St Lukes Way
Ste 115
The Woodlands, TX 77384
Phone (936) 273-4437

11439 Spring Cypress Rd
Unit B
Tomball, TX 77377
Phone (936) 273-4437

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1689127995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785771614",
            "telephone_number": "956-362-2171",
            "fax_number": "956-627-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 MICHAELANGELO DR",
            "address_2": "STE303",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785391404",
            "telephone_number": "956-362-2490",
            "fax_number": "956-362-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVAREZ",
        "first_name": "DOMINIQUE",
        "middle_name": "LIZETTE",
        "name_prefix": "Mrs.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-03",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "80750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.