MEDICARE: DAVID M COTLAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	E0864	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00BA36	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1285612929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID M COTLAR M.D.

Provider Business Mailing Address
First Line	:	7777 SW FWY
Second Line	:	SUITE 946
City	:	HOUSTON
State	:	TX
Zip	:	77074-1802
Country	:	US
Telephone Number	:	713-776-3045
Fax Number	:	713-776-2402

Provider Business Practice Location Address
First Line	:	7777 SW FWY
Second Line	:	SUITE 946
City	:	HOUSTON
State	:	TX
Zip	:	77074-1802
Country	:	US
Telephone Number	:	713-776-3045
Fax Number	:	713-776-2402

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	07/08/2007

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Directions to “ DAVID M COTLAR M.D.” Practice Location

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