Individual
JACQUELINE S OTAMIRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSA
Contact information
Practice address
9355 JOHN W ELLIOTT DR STE 25461, FRISCO, TX 75033-3665
(214) 227-2457
(214) 764-0880
Mailing address
PO BOX 2550, ROWLETT, TX 75030-2550
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
186634
TX
246ZC0007X
Surgical Assistant
Primary
SA00870
TX
Other
Enumeration date
04/12/2013
Last updated
12/27/2021
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