Individual provider Active NPI

Liz V Oliver, FNP

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1780943258
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP121785 Issued in TX
Practice address
4204 Gardendale St
Ste 312
San Antonio, TX 78229-3132
Phone
(210) 293-6006
Fax
(210) 614-1722
NPI assigned
May 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP121785 TX Primary

Addresses

Primary practice location

4204 Gardendale St
Ste 312
San Antonio, TX 78229-3132

Mailing address

4204 Gardendale St
Ste 312
San Antonio, TX 78229-3132
Phone (210) 293-6006

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120621000712 TX Practitioner - Nurse Practitioner 1759546849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC Provider Group PLLCGroup PAC ID 6305149121, 213 clinicians

Practice addresses (Care Compare)

23611W Interstate 10
San Antonio, TX 78257-1694
Phone (210) 698-6617

6530 W Loop 1604
San Antonio, TX 78254-6319
Phone (210) 476-5577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP121785TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Provider Group PLLC Current Accepting new patients
TMC Provider Group PLLC CurrentSince Aug 1, 2016 Accepting new patients
TMC Provider Group PLLC CurrentSince Aug 1, 2016 Accepting new patients

Locations

9900 S Interstate 35
Austin, TX 78748
Phone (512) 291-5577

13722 Embassy Row
San Antonio, TX 78216
Phone (210) 349-5577

23611 W Interstate 10
San Antonio, TX 78257
Phone (210) 698-6617

Organizations & group practices 3

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": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1780943258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 GARDENDALE ST",
            "address_2": "STE 312",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293132",
            "telephone_number": "210-293-6006",
            "fax_number": "210-614-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4204 GARDENDALE ST",
            "address_2": "STE 312",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293132",
            "telephone_number": "210-293-6006",
            "fax_number": "210-614-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "LIZ",
        "middle_name": "V",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP121785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.