=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235236787
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | COTTON DANIEL FERAY M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2006
-----------------------------------------------------
Last Update Date | 12/06/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 720 LAWRENCE ST. SUITE 100
-----------------------------------------------------
City | TOMBALL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77375
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-351-5922
-----------------------------------------------------
Fax | 281-255-3016
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6402 HICKORYCREST
-----------------------------------------------------
City | SPRING
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77389
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-379-6244
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | D7031
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------