Provider Demographics
NPI:1306172945
Name:ARRIETA, OMAR STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:OMAR
Middle Name:STEVEN
Last Name:ARRIETA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:805 1/2 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-5826
Mailing Address - Country:US
Mailing Address - Phone:412-983-5364
Mailing Address - Fax:
Practice Address - Street 1:SCOTT & WHITE 4 SOUTH PEDI ADMINISTRATION RM 431
Practice Address - Street 2:2401 SOUTH 31ST STREET
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508-0001
Practice Address - Country:US
Practice Address - Phone:254-724-4363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-01
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4260208D00000X
TXTEMP MED LICENSE2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice