Provider Demographics
NPI:1780827949
Name:OTOOLE, MEGAN (DO)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:OTOOLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14439 NW MILITARY HWY STE 242
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1646
Mailing Address - Country:US
Mailing Address - Phone:210-942-0292
Mailing Address - Fax:210-467-5848
Practice Address - Street 1:18707 HARDY OAK BLVD STE 435
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4792
Practice Address - Country:US
Practice Address - Phone:210-942-0292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-16
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS6009208600000X, 2086S0122X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery