Provider Demographics
NPI:1922370865
Name:JOHN P. OTT JR. MD PLLC
Entity Type:Organization
Organization Name:JOHN P. OTT JR. MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:OTT
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:713-806-6605
Mailing Address - Street 1:1201 DAIRY ASHFORD ST
Mailing Address - Street 2:SUITE 118
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-3023
Mailing Address - Country:US
Mailing Address - Phone:713-806-6605
Mailing Address - Fax:
Practice Address - Street 1:1201 DAIRY ASHFORD ST
Practice Address - Street 2:SUITE 118
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-3023
Practice Address - Country:US
Practice Address - Phone:713-806-6605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty