Provider Demographics
NPI:1528083136
Name:OLIVER, DONALD R (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:R
Last Name:OLIVER
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:6110 SYLLING DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-6128
Mailing Address - Country:US
Mailing Address - Phone:361-815-1302
Mailing Address - Fax:361-232-4964
Practice Address - Street 1:1028 S 14TH ST
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-6422
Practice Address - Country:US
Practice Address - Phone:361-815-1302
Practice Address - Fax:361-232-4964
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2013-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1132884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist