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Individual

DR. SUMMER D. OTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
6400 FANNIN ST, SUITE 1620, HOUSTON, TX 77030-2761
(713) 704-9647
(713) 704-0991
Mailing address
6400 FANNIN, SUITE 1620, HOUSTON, TX 77030-2761
(713) 704-9647
(713) 704-0991

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
33628
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043406655
BLUE CROSS BLUE SHIELD
TX
05
192738601
TX
05
192738602
TX
01
87447A
BCBS TX
TX
Enumeration date
09/18/2007
Last updated
05/09/2012
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