Otto Penalver Pacheco, APRN CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1023204 Issued in TX

Practice address

23217 Red River Dr
Katy, TX 77494-2031

Phone

(832) 913-3262

NPI assigned

Jul 17, 2024

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1902644545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21023 BELMONT VILLAGE WAY",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774493193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23217 RED RIVER DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774942031",
            "telephone_number": "832-913-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENALVER PACHECO",
        "first_name": "OTTO",
        "credential": "APRN CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1023204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Pena, RBT, CPR
• Georgina Pena
• Lucy J Pena
• Maiya Pena
• Bladimir Antonio Penado, DC
• Sarah Elizabeth Pencak, BCBA
• Joshua Jia Peng, DDS
• Kimberly R. Pengra, PA
• Bertha Doris Peoples
• Bianca Ivonne Perales

• Family Nurse Practitioner in Katy, TX
• Providers in Katy, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.