Basic Information
| Provider Information | |||||||||
| NPI: | 1598110371 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OLIVAR | ||||||||
| FirstName: | FRANKIE | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10950 PELLICANO DR | ||||||||
| Address2: | BLDG B, STE B-2 | ||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799354616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9154912033 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10950 PELLICANO DR | ||||||||
| Address2: | BLDG B, STE B-2 | ||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799354616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9154912033 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2016 | ||||||||
| LastUpdateDate: | 04/28/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 111495 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.