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General NPI Number Information
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NPI Number | 1770876617
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Entity Type | Individual
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Provider Name | CHRISTINA SUSANA O'HARA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/25/2011
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 3551 ROGER BROOKE DR
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 423-727-7044
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Fax |
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Provider Business Mailing Address
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Address Line | 9 DEVON WOOD
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1208
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Country | US
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Telephone | 423-737-7044
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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 | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 01072639A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 01072639A
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License Number State | IN
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