Charles O Olisa, MD | |
445 E Fm 1382, Suite 3- 265, Cedar Hill, TX 75104 | |
(469) 744-8844 | |
Not Available |
Full Name | Charles O Olisa |
---|---|
Gender | Male |
Speciality | Hospitalist |
Experience | 21 Years |
Location | 445 E Fm 1382, Cedar Hill, Texas |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265582837 | NPI | - | NPPES |
008839400 | Medicaid | FL | |
11948268 | Other | IN | CAQH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 01066108A (Indiana) | Secondary |
208M00000X | Hospitalist | 01066108A (Indiana) | Secondary |
208M00000X | Hospitalist | MD205030 (Louisiana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Lane Regional Medical Center | Zachary, LA | Hospital |
Our Lady Of The Lake Regional Medical Center | Baton rouge, LA | Hospital |
St Francis Medical Center | Monroe, LA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Our Lady Of The Lake Physician Group Llc | 4587849781 | 521 |
Entity Name | Northern Louisiana Emergency Physicians, Llp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588828172 PECOS PAC ID: 9638246846 Enrollment ID: O20080930000036 |
Entity Name | Northern Louisiana Emergency Physicians, Llp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598995847 PECOS PAC ID: 9638246846 Enrollment ID: O20090903000029 |
Entity Name | Our Lady Of The Lake Physician Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377 |
Entity Name | Lc Hospital Medicine Physicians, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417654724 PECOS PAC ID: 9739546805 Enrollment ID: O20230605001940 |
Mailing Address | Practice Location Address |
---|---|
Charles O Olisa, MD 445 E Fm 1382, Suite 3 - 265, Cedar Hill, TX 75104-5104 Ph: (469) 744-8844 | Charles O Olisa, MD 445 E Fm 1382, Suite 3- 265, Cedar Hill, TX 75104 Ph: (469) 744-8844 |