Healthcare Provider Details

I. General information

NPI: 1124313721
Provider Name (Legal Business Name): TIMOTHY ERNEST HOTZE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6720 BERTNER AVE
HOUSTON TX
77030-2604
US

IV. Provider business mailing address

6720 BERTNER AVE
HOUSTON TX
77030-2604
US

V. Phone/Fax

Practice location:
  • Phone: 713-798-1000
  • Fax:
Mailing address:
  • Phone: 713-798-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberS2561
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberQ2561
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberQ2561
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: