Provider Demographics
NPI:1902585433
Name:OLIVER, MERCEDES (CERT PHLEBOTOMIST)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:CERT PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 LARKSPUR ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-4026
Mailing Address - Country:US
Mailing Address - Phone:832-834-0978
Mailing Address - Fax:
Practice Address - Street 1:4925 LARKSPUR ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033-4026
Practice Address - Country:US
Practice Address - Phone:832-834-0978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4Q5D9P6246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty