Provider Demographics
NPI:1407123979
Name:EBERHARD C LOTZE, M.D.
Entity Type:Organization
Organization Name:EBERHARD C LOTZE, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EBERHARDT
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOTZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-860-0988
Mailing Address - Street 1:9333 MEMORIAL DR APT 105
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-5735
Mailing Address - Country:US
Mailing Address - Phone:713-860-0988
Mailing Address - Fax:
Practice Address - Street 1:9333 MEMORIAL DR APT 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-5735
Practice Address - Country:US
Practice Address - Phone:713-860-0988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD2510207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty