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General NPI Number Information
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NPI Number | 1376914101
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Entity Type | Individual
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Provider Name | MATTHEW COTTON FNP
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Gender | Male
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 10/20/2015
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Provider Practice Location Address
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Address Line | 2424 QUAKER AVE
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City | LUBBOCK
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State | TX
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Zip | 79410
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Country | US
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Telephone | 806-368-8782
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Fax |
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Provider Business Mailing Address
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Address Line | 5916 102ND ST.
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City | LUBBOCK
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State | TX
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Zip | 79424
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Country | US
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Telephone | 806-535-6897
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP129303
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License Number State | TX
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