Individual provider · NPI-1
Charles O Olisa, MD
Hospitalist · Cedar Hill, TX
NPI number1265582837
StatusActive
Last updated in NPPESJan 11, 2024
Details
- NPI
- 1265582837
- Entity type
- Individual (NPI-1)
- Name
- Charles O Olisa
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 12, 2007
- Certification date
- Jan 11, 2024
- Last updated
- Jan 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208M00000X | Hospitalist | MD205030 | LA | Yes |
| 207R00000X | Internal Medicine | 01066108A | IN | |
| 208M00000X | Hospitalist | 01066108A | IN |
Practice location
445 E Fm 1382Suite 3- 265
Cedar Hill, TX 75104
Phone 469-744-8844
Mailing address
445 E Fm 1382Suite 3 - 265
Cedar Hill, TX 75104-5104
Phone 469-744-8844
Other practice locations
309 Jackson St
Monroe, LA 71201-7407
Monroe, LA 71201-7407
Phone 318-966-4541 · Fax 318-966-4543
600 Mary St
Evansville, IN 47710-1658
Evansville, IN 47710-1658
Phone 812-450-3036 · Fax 812-450-2193
4011 Gateway Blvd
Newburgh, IN 47630-8947
Newburgh, IN 47630-8947
Phone 812-450-3036 · Fax 812-450-2193
6300 Main St
Zachary, LA 70791-4037
Zachary, LA 70791-4037
Phone 225-765-4050
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