Healthcare Provider Details

I. General information

NPI: 1851376008
Provider Name (Legal Business Name): FRANCISCO JAVIER OTERO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 12/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 E 32ND ST SUITE 508
AUSTIN TX
78705-2708
US

IV. Provider business mailing address

5301 RIATA PARK COURT BLDG D, SUITE 200
AUSTIN TX
78727-3438
US

V. Phone/Fax

Practice location:
  • Phone: 512-617-6000
  • Fax: 512-480-3153
Mailing address:
  • Phone: 512-617-6000
  • Fax: 512-615-0459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberK6205
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: