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General NPI Number Information
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NPI Number | 1265617799
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Entity Type | Organization
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Legal Business Name | SOUTHSHORE FAMILY MEDICINE, P.A.
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 400 W MEDICAL CENTER BLVD STE 215
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City | WEBSTER
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State | TX
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Zip | 77598-4227
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Country | US
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Telephone | 281-316-1033
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Fax | 281-316-1066
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Provider Business Mailing Address
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Address Line | 2640 E LEAGUE CITY PKWY SUITE 114
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City | LEAGUE CITY
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State | TX
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Zip | 77573-3368
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Country | US
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Telephone | 281-538-8000
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Fax | 281-538-8009
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | JOHN THOMAS COTTINGHAM
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Credential |
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Telephone | 281-316-1033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M5111
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License Number State | TX
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