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Individual
DR. RANDAL A OTTO
Active
Individual
DR. RANDAL A OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
H6911
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120153506
—
TX
01
—
120153507
CSHCN
TX
Enumeration date
08/10/2006
Last updated
11/13/2009
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