Provider Demographics
NPI:1265496707
Name:OTERO, FERNANDO JAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:JAVIER
Last Name:OTERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-6001
Mailing Address - Country:US
Mailing Address - Phone:956-603-1600
Mailing Address - Fax:956-603-1601
Practice Address - Street 1:3401 N 23RD ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-6001
Practice Address - Country:US
Practice Address - Phone:956-603-1600
Practice Address - Fax:956-603-1601
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4619207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153061004Medicaid
TX153061002Medicaid