Individual
MIKI OTA I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10301 GATEWAY BLVD W, EL PASO, TX 79925-7701
(915) 263-5101
Mailing address
10301 GATEWAY BLVD W, EL PASO, TX 79925-7701
(915) 263-5101
Taxonomy
Speciality
Code
Description
License number
State
1835C0205X
Critical Care Pharmacist
Primary
48274
TX
Other
Enumeration date
09/05/2025
Last updated
09/05/2025
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