Provider Demographics
NPI:1285395053
Name:OLIVER, JAMES (RD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:OLIVER
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W BITTERS RD APT 608
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7940
Mailing Address - Country:US
Mailing Address - Phone:210-286-6532
Mailing Address - Fax:
Practice Address - Street 1:1870 W BITTERS RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1827
Practice Address - Country:US
Practice Address - Phone:210-545-4422
Practice Address - Fax:888-582-7143
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86065420133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered