Provider Demographics
NPI:1972767176
Name:OLEA, ALEXANDER S (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:S
Last Name:OLEA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 WILLOW KNOLL CV
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7850
Mailing Address - Country:US
Mailing Address - Phone:415-450-8994
Mailing Address - Fax:
Practice Address - Street 1:803 WILLOW KNOLL CV
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-7850
Practice Address - Country:US
Practice Address - Phone:415-450-8994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX187721223P0221X, 1223D0004X
WADE000100261223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology
No1223P0221XDental ProvidersDentistPediatric Dentistry