Individual
DR. RAFAEL F OTERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5425 PLAZA DR, TEXARKANA, TX 75503-1662
(903) 838-3711
(903) 838-8879
Mailing address
5425 PLAZA DR, TEXARKANA, TX 75503-1662
(903) 838-3711
(903) 838-8879
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
85-3P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80433
AR BC/BS
AR
Enumeration date
06/30/2006
Last updated
01/28/2008
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