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Rebecca A. Olivares

Family Medicine

Allopathic & Osteopathic Physicians

426 Castroville Rd, Ste 1, San Antonio, TX 78207-5169

PECOS Enrollment

This provider is enrolled in PECOS as REBECCA OLIVARES.

Based on the most recent information from CMS, provider Rebecca A. Olivares is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1417971938
Provider Type
Individual
Full Name
Olivares, Rebecca A.
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/27/2006
Last Updated
8/14/2018

Contact Information

Practice Location

426 Castroville Rd, Ste 1, San Antonio, TX 78207-5169

(210) 922-2270

(210) 922-2292

Mailing Location

426 Castroville Rd, Ste 1, San Antonio, TX 78207-5169

(210) 922-2270

(210) 922-2292

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License G5446 Texas

Provider Identifiers

ID	Description	Issuer
ID 133461706	Description Medicaid	Issuer Unlisted Texas
ID 133461702	Description Medicaid	Issuer Unlisted Texas

Rebecca A. Olivares

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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Coston, Matthew Jason

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Blanchett, Michael G.

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Labahn, Jacob

Lee, Kenyatta Y

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Martinez, Rafael

Sood, Neil Rohan