Medical school: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduated: 1993
NPI: 1225001860
Practice Locations (2)
OLIVER STREET 5.01(A) INC
401 HOSPITAL DR, SUITE 100
CORSICANA, TX 751102415
9038750413
OLIVER STREET 5.01(A) INC
1367 DOMINION PLZ
TYLER, TX 757031013
9035346200
Source: CMS National Downloadable File, September 2026.