Individual
PAMELA OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
J4951
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102379801
—
TX
01
—
102379802
CSHCN
TX
Enumeration date
08/10/2006
Last updated
05/06/2009
Update your record
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