Healthcare Provider Details

I. General information

NPI: 1487304408
Provider Name (Legal Business Name): MICHAEL HOTTMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 03/24/2022
Certification Date: 03/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 CAMBRIDGE ST
HOUSTON TX
77030-4202
US

IV. Provider business mailing address

2903 BURNSIDE DR
SAN ANTONIO TX
78209-3012
US

V. Phone/Fax

Practice location:
  • Phone: 713-798-6151
  • Fax:
Mailing address:
  • Phone: 575-640-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberNA
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: