Individual ProviderDiego Alonso Olavarria BernalStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice AddressDepartment Of Internal Medicine 3601 4th Street Ms 9410, Lubbock, TX 79430-0001(806) 743-6840PECOS EnrollmentBased on the most recent information from CMS, provider Diego Alonso Olavarria Bernal does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1700561875Provider TypeIndividualFull NameOlavarria Bernal, Diego AlonsoCredentialMDGenderMaleSole ProprietorNoEnumeration Date6/16/2023Last Updated6/16/2023Contact InformationPractice LocationPractice AddressDepartment Of Internal Medicine 3601 4th Street Ms 9410, Lubbock, TX 79430-0001Phone(806) 743-6840FaxUnlisted FaxMailing LocationMailing AddressDepartment Of Internal Medicine 3601 4th Street Ms 9410, Lubbock, TX 79430-0001Phone(806) 743-6840FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseBP10083588Texas