Provider Demographics
NPI:1194903179
Name:HUA, OLIVIA S (RN, FNP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:S
Last Name:HUA
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16820
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-6820
Mailing Address - Country:US
Mailing Address - Phone:713-668-4100
Mailing Address - Fax:713-668-4105
Practice Address - Street 1:2201 W HOLCOMBE BLVD STE 325
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2042
Practice Address - Country:US
Practice Address - Phone:713-668-4100
Practice Address - Fax:713-668-4105
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP115709363L00000X
TX650735363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192834305Medicaid