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NPI Code Detail

MEDICARE: DR. BRITTANY ROCHELLE POTTER M.D.

MEDICARE: DR. BRITTANY ROCHELLE POTTER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianN4677TX
2207QS0010XSports Medicine (Family Medicine) PhysicianN4677TX

General Provider Information

NPI Number : 1164679429
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRITTANY ROCHELLE POTTER M.D.
Provider Business Mailing Address
First Line : PO BOX 222093
Second Line :
City : DALLAS
State : TX
Zip : 75222-2093
Country : US
Telephone Number : 972-291-9165
Fax Number : 469-575-9975
Provider Business Practice Location Address
First Line : 716 N HIGHWAY 67 STE 2
Second Line :
City : CEDAR HILL
State : TX
Zip : 75104-2117
Country : US
Telephone Number : 972-291-9165
Fax Number : 469-575-9975
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2008
Last Update Date : 12/01/2017

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