Healthcare Provider Details

I. General information

NPI: 1336774520
Provider Name (Legal Business Name): LEAH OTTO DNP, AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH SEIM-BROWN RN

II. Dates (important events)

Enumeration Date: 03/08/2020
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 FLOYD CURL DR
SAN ANTONIO TX
78229-3931
US

IV. Provider business mailing address

8300 FLOYD CURL DR
SAN ANTONIO TX
78229-3931
US

V. Phone/Fax

Practice location:
  • Phone: 210-450-9960
  • Fax: 210-450-2139
Mailing address:
  • Phone: 210-450-9960
  • Fax: 210-450-2139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60225746
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1020730
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1020730
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1020730
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: