Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
OLIVIA LAKE
ActiveOLIVIA LAKE is a Specialist/Technologist, Surgical healthcare provider located in FORT WORTH, Texas. NPI 1073289955 is currently active in the NPPES registry. Verify at CMS.
Specialist/Technologist, Surgical · FORT WORTH, TX
Registration Details
- NPI Number
- 1073289955
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 19, 2021 (4.9465627064638 yrs)
- Last Updated
- Aug 19, 2021
Practice Information
- Address
-
111 BOLAND ST # 210FORT WORTH, TX, 761071263Browse TX providers · Browse ZIP 76107
- Phone
- 8175298485
- Fax
- 4694535075
- Primary Specialty
-
Specialist/Technologist, Surgical
246Z00000X
Other Specialist/Technologist, Surgical Providers in FORT WORTH, TX
| Name | Credential | NPI |
|---|---|---|
| JOSE SANTANA JR. | CST | 1881992097 |
| BRUCE DODD | A.T.P. | 1063792943 |
| LESLIE PAUL DULA | L.A.T. | 1598210817 |
| DA'RESSA ANDREWS | — | 1053995381 |
| AARON J ALTERMAN | — | 1598431470 |
| SHANNON SALLEY | — | 1982370862 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.