Provider Demographics
NPI:1013682111
Name:FLOTTE, ROBERTO CARLOS
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:CARLOS
Last Name:FLOTTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2161 E 42ND ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-5842
Mailing Address - Country:US
Mailing Address - Phone:432-367-0738
Mailing Address - Fax:
Practice Address - Street 1:2161 E 42ND ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5842
Practice Address - Country:US
Practice Address - Phone:432-367-0738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX69117OtherTEXAS STATE BOARD OF PHARMACY