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General NPI Number Information
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NPI Number | 1093901316
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Entity Type | Organization
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Legal Business Name | OTONIEL HUERTAS M.D.
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 04/28/2014
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Provider Practice Location Address
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Address Line | 7557 RAMBLER RD STE 100
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City | DALLAS
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State | TX
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Zip | 75231-4142
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Country | US
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Telephone | 972-279-9000
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Fax | 972-279-9008
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Provider Business Mailing Address
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Address Line | 7557 RAMBLER RD STE 100
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City | DALLAS
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State | TX
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Zip | 75231-4142
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Country | US
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Telephone | 972-279-9000
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Fax | 972-279-9008
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Authorized Official
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Title or Position | PRESIDENT
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Name | OTONIEL HUERTAS
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Credential | M.D.
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Telephone | 972-279-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | K9806
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License Number State | TX
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