Healthcare Provider Details

I. General information

NPI: 1891803243
Provider Name (Legal Business Name): KIMBERLY ANNE HOTT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HERRING AVE
WACO TX
76708-3239
US

IV. Provider business mailing address

116 GREENTREE DR
CRAWFORD TX
76638-2770
US

V. Phone/Fax

Practice location:
  • Phone: 254-202-8611
  • Fax:
Mailing address:
  • Phone: 254-848-4095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberL4447
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: