Provider Demographics
| NPI: | 1114167996 |
|---|---|
| Name: | OLBRISH, STEPHEN R JR (RRT) |
| Entity type: | Individual |
| Prefix: | MR |
| First Name: | STEPHEN |
| Middle Name: | R |
| Last Name: | OLBRISH |
| Suffix: | JR |
| Gender: | M |
| Credentials: | RRT |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 2558 ABBEY CT |
| Mailing Address - Street 2: | |
| Mailing Address - City: | ROCKWALL |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 75032 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 972-722-8261 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 2558 ABBEY CT |
| Practice Address - Street 2: | |
| Practice Address - City: | ROCKWALL |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 75032-7368 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 972-722-8261 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | Yes |
| Enumeration Date: | 2009-03-06 |
| Last Update Date: | 2009-03-06 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| TX | 55666 | 2278E1000X, 2278G0305X, 2278P1004X, 2279C0205X, 2279E0002X, 2279P1005X, 2279P3900X, 2279S1500X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 2279C0205X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Critical Care |
| No | 2278E1000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Educational |
| No | 2278G0305X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Geriatric Care |
| No | 2278P1004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Pulmonary Diagnostics |
| No | 2279E0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Emergency Care |
| No | 2279P1005X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Pulmonary Rehabilitation |
| No | 2279P3900X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Neonatal/Pediatrics |
| No | 2279S1500X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | SNF/Subacute Care |