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General NPI Number Information
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NPI Number | 1689848061
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Entity Type | Individual
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Provider Name | LAURIE OTTO MD
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Gender | Female
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 3308 PRESTON RD, STE 350, #224
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City | PLANO
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State | TX
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Zip | 75093-7471
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Country | US
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Telephone | 972-900-0738
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Fax | 972-378-3970
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Provider Business Mailing Address
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Address Line | 3308 PRESTON RD, STE 350, #224
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City | PLANO
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State | TX
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Zip | 75093-7471
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Country | US
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Telephone | 972-900-0738
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Fax | 972-378-3970
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | J1749
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License Number State | TX
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