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General NPI Number Information
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NPI Number | 1134531080
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Entity Type | Individual
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Provider Name | OTILIA LAZCANO APRN, FNP-C, LSA
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Gender | Female
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 4515 N LOOP 1604 W STE 301
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City | SAN ANTONIO
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State | TX
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Zip | 78249-4588
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Country | US
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Telephone | 210-404-2229
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Fax | 726-204-8019
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Provider Business Mailing Address
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Address Line | 20211 HUEBNER RD APT 1011
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3277
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Country | US
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Telephone | 713-269-7466
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1148572
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 12-230
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License Number State | TX
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