Provider Demographics
NPI:1316178502
Name:OTERO, CHRISTIAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:A
Last Name:OTERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79604-1198
Mailing Address - Country:US
Mailing Address - Phone:325-370-3700
Mailing Address - Fax:325-370-3789
Practice Address - Street 1:1150 N 18TH ST STE 401
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2931
Practice Address - Country:US
Practice Address - Phone:325-670-4560
Practice Address - Fax:325-670-4559
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN10628208600000X
FLTRN14433208600000X
OHCREDENTIAL 57.01570208600000X
FLME130909208G00000X
TXS5457208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery