Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Charles Daniel Otero, PA

Individual provider Physician Assistant · NPI 1255375903

Mr. Charles Daniel Otero, PA is a Physician Assistant in Clovis, New Mexico. Qualified in 1992, 34 years ago. Accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
34
Licensed in
NM
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

701 Arizona St Ste A
Clovis, NM 88101-2110
Phone: (575) 742-3033
Fax: (575) 742-1133
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 93-PA01 (NM)

Record details

NPI number1255375903
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 15, 2006
Last updated in NPPESDecember 27, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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