Provider Demographics
NPI:1558073692
Name:OLIVER, COLE FRANKLIN (PA)
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:FRANKLIN
Last Name:OLIVER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7401 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4509
Mailing Address - Country:US
Mailing Address - Phone:713-799-2300
Mailing Address - Fax:833-520-1440
Practice Address - Street 1:7401 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4509
Practice Address - Country:US
Practice Address - Phone:713-799-2300
Practice Address - Fax:833-520-1440
Is Sole Proprietor?:No
Enumeration Date:2022-12-20
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16453363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant