Individual
MR. BARACK AUSTINE OTIENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
105 HARRIS AVE, RED OAK, TX 75154-4216
(866) 389-2727
Mailing address
5116 SANTA ROSA DR, ARLINGTON, TX 76001-3118
(866) 389-2727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP131642
TX
Other
Enumeration date
08/10/2016
Last updated
12/10/2022
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