Healthcare Provider Details

I. General information

NPI: 1164935359
Provider Name (Legal Business Name): STEPHANIE GOTCHER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2017
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19701 KINGWOOD DR BLDG 5
KINGWOOD TX
77339-3773
US

IV. Provider business mailing address

1200 BINZ ST STE 1490
HOUSTON TX
77004-6946
US

V. Phone/Fax

Practice location:
  • Phone: 281-319-8101
  • Fax:
Mailing address:
  • Phone: 713-512-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberAP135770
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: