Individual provider Active NPI

Adriana Olivares, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Hurst, TX
National Provider Identifier
1750385142
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
K6914 Issued in TX
Practice address
900 Airport Fwy Ste 132
Hurst, TX 76054-3252
Phone
(817) 514-4005
Fax
(817) 576-0591
NPI assigned
Jun 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X K6914 TX Primary

Addresses

Primary practice location

900 Airport Fwy Ste 132
Hurst, TX 76054-3252

Mailing address

900 Airport Fwy Ste 132
Hurst, TX 76054-3252
Phone (817) 514-4005

Other identifiers 1

IdentifierTypeStateIssuer
1722365MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041202000431 TX Practitioner - Pathology 6507822491 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K6914TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Urology Institute PC Anatomic Pathology & Clinical Pathology CurrentSince Apr 29, 2010 Accepting new patients
Urology Associates of South Texas PA Past Accepting new patients
Urology Tyler, PA Past Accepting new patients
Urology Care, Inc. Past Accepting new patients
Northwoods Urology Association Past Accepting new patients
Northwoods Urology Association Past Accepting new patients

Locations

2400 Hartman Ln
Ste 100
Springfield, OR 97477
Phone (541) 334-3350

7909 Fredericksburg Rd
Ste 150
San Antonio, TX 78229
Phone (210) 521-7700

Organizations & group practices 6

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1750385142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 AIRPORT FWY STE 132",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543252",
            "telephone_number": "817-514-4005",
            "fax_number": "817-576-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 AIRPORT FWY STE 132",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543252",
            "telephone_number": "817-514-4005",
            "fax_number": "817-576-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVARES",
        "first_name": "ADRIANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "K6914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1722365",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurst, TX

Sources for this page

Verify at the official NPI Registry.