Individual
DR. MARK RAYMOND OTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2925 LBJ FREEWAY, SUITE 180, DALLAS, TX 75234-7619
(972) 241-0674
Mailing address
2925 LBJ FREEWAY, SUITE 180, DALLAS, TX 75234-7619
(972) 241-0674
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
22147
TX
Other
Enumeration date
08/25/2006
Last updated
07/08/2007
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