CAITLIN C. OETKEN PA-C NPI 1912390253

NPI Information

NPI: 1912390253
Provider Name: CAITLIN C. OETKEN, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: TEXAS ENT CENTER PA

PECOS Registration: Yes

Address:
4601 HERITAGE TRACE PKWY
FORT WORTH, TX
ZIP 76244
Phone: (817) 431-7985
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Caitlin C. Oetken, PA-C is a medical physician assistant in Fort Worth, TX with 10 years of experience. Caitlin C. Oetken, PA-C NPI is 1912390253. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4601 HERITAGE TRACE PKWY
FORT WORTH, TX
ZIP 76244-905
Phone: (817) 431-7985

The NPI 1912390253 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/11/2015 and was last updated on 6/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA12191	TEXAS	Yes
2	363AM0700X	Physician Assistant	Medical	PA9108543	FLORIDA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	014517600	MEDICAID	FLORIDA
2	Y0R0Q	OTHER	FLORIDA	BCBS
3	IC674Z	OTHER	FLORIDA	MCR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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