1114385309 NPI number — MR. JOSEPH RAMUTA OLEARY ADULT NURSE PRACTITI

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114385309 NPI number — MR. JOSEPH RAMUTA OLEARY ADULT NURSE PRACTITI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLEARY
Provider First Name:
JOSEPH
Provider Middle Name:
RAMUTA
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
ADULT NURSE PRACTITI
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114385309
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 WALLER STREET, RBJ BLDG.
Provider Second Line Business Mailing Address:
AUSTIN/TRAVIS COUNTY HEALTH & HUMAN SERVICES
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78702-5240
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-972-5429
Provider Business Mailing Address Fax Number:
512-972-5451

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 WALLER STREET, RBJ BLDG.
Provider Second Line Business Practice Location Address:
AUSTIN/TRAVIS COUNTY HEALTH & HUMAN SERVICES
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78702-5240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-972-5429
Provider Business Practice Location Address Fax Number:
512-972-5451
Provider Enumeration Date:
02/03/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  110403 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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