MEDICARE: DR. LOUIS EDWARD POTTKOTTER 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
1	208000000X	Pediatrics Physician	E4603	TX

General Provider Information

NPI Number	:	1396804159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS EDWARD POTTKOTTER M.D.

Provider Business Mailing Address
First Line	:	3425 HIGHWAY 6 STE 109
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4439
Country	:	US
Telephone Number	:	281-265-7800
Fax Number	:

Provider Business Practice Location Address
First Line	:	3425 HIGHWAY 6 STE 109
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4439
Country	:	US
Telephone Number	:	281-265-7800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2006
Last Update Date	:	07/08/2007

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