Individual
DR. CHARLES E. OLTORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3313 WINDSOR RD, AUSTIN, TX 78703-2263
(512) 391-9025
Mailing address
3313 WINDSOR RD, AUSTIN, TX 78703-2263
(512) 391-9025
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D5139
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010100-01
—
TX
01
—
1010100-02
CSHCN
TX
01
—
370017485
RR/MEDICARE
TX
01
—
807446
BLUE SHIELD
TX
Enumeration date
03/28/2006
Last updated
03/03/2008
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