Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | D9598 | TX |
N | 208600000X | Surgeon | D9598 | TX |
N | 2086S0129X | Vascular Surgeon | D9598 | TX |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | D9598 | TX |
NPI | 1093802530 |
---|---|
Provider Name | David A. Ott |
First Address | Houston, TX 77225-0345 |
Second Address | Houston, TX 77030-2607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 09/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
780000003 | RR MEDICARE (01) | TX |