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General NPI Number Information
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NPI Number | 1538278767
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Entity Type | Individual
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Provider Name | JAMES EDWARD OTTE L.P.C.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1800 WEST FWY SUITE D
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City | FORT WORTH
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State | TX
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Zip | 76102-5930
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Country | US
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Telephone | 972-741-9407
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Fax |
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Provider Business Mailing Address
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Address Line | 4205 SPARKFORD CT
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City | ARLINGTON
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State | TX
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Zip | 76013-5514
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Country | US
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Telephone | 817-446-0526
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 14394
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License Number State | TX
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