Provider Demographics
NPI:1104970136
Name:OLIVA, CLAUDE MICHEL (MD PA)
Entity type:Individual
Prefix:DR
First Name:CLAUDE
Middle Name:MICHEL
Last Name:OLIVA
Suffix:
Gender:
Credentials:MD PA
Other - Prefix:DR
Other - First Name:C
Other - Middle Name:MICHEL
Other - Last Name:OLIVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PA
Mailing Address - Street 1:PO BOX 64123
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79464-4123
Mailing Address - Country:US
Mailing Address - Phone:806-791-3377
Mailing Address - Fax:806-791-3378
Practice Address - Street 1:4404 6TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-4732
Practice Address - Country:US
Practice Address - Phone:806-791-3377
Practice Address - Fax:806-791-3378
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8299208VP0014X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089795101Medicaid
TXOOL79CMedicare ID - Type Unspecified
TX089795101Medicaid