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Dr. Roderick Taan Olivas, MD
Student in an Organized Health Care Education/Training Program in Lubbock, Texas
NPI 1295294684

Roderick Taan Olivas is a Student in an Organized Health Care Education/Training Program based in Lubbock, TX. Roderick Taan Olivas practices in Lubbock, TX and has the professional credentials of MD. The NPI Number for Roderick Taan Olivas is 1295294684 and holds a License No. U7920 (Texas).

The current practice location address for Roderick Taan Olivas is 3601 4Th St Stop 6211, Lubbock, TX and can be reached out via phone at 806-743-2978 and via fax at 806-743-1599.

Location: 3601 4Th St Stop 6211, Lubbock, TX, 79430-6211
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1295294684
Provider Name
Roderick Taan Olivas
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
3601 4Th St Stop 6211, Lubbock, TX, 79430-6211
Phone Number
806-743-2978
Fax Number
806-743-1599
Provider Enumeration Date
03/15/2019
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
3601 4Th St Stop 6211
City
Lubbock
State
Texas
Zip
79430-5881
Phone Number
806-743-2978
Fax Number
806-743-1599
person
Provider Business Mailing Address Details
Address
3601 4Th St Stop 6211
City
Lubbock
State
Texas
Zip
79430-5881
Phone Number
806-743-2978
Fax Number
806-743-1599
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
U7920 (Texas)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
U7920 (Texas)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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