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NPI Code Detail

MEDICARE: MRS. DENICE OTERO

MEDICARE: MRS. DENICE OTERO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist108562TX

General Provider Information

NPI Number : 1033457999
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DENICE OTERO
Provider Business Mailing Address
First Line : 1601 N COLLINS BLVD
Second Line :
City : RICHARDSON
State : TX
Zip : 75080-3520
Country : US
Telephone Number : 972-470-5855
Fax Number :
Provider Business Practice Location Address
First Line : 1601 N COLLINS BLVD
Second Line :
City : RICHARDSON
State : TX
Zip : 75080-3520
Country : US
Telephone Number : 972-470-5855
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2013
Last Update Date : 06/03/2015

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Directions to “ MRS. DENICE OTERO ” Practice Location

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