Provider Demographics
NPI:1639171903
Name:LOTZE, PETER M (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:M
Last Name:LOTZE
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 FANNIN ST STE 4000
Mailing Address - Street 2:WOMEN'S PELVIC RESTORATIVE CENTER PLLC
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2935
Mailing Address - Country:US
Mailing Address - Phone:713-512-7600
Mailing Address - Fax:713-512-7873
Practice Address - Street 1:7900 FANNIN ST STE 4000
Practice Address - Street 2:WOMEN'S PELVIC RESTORATIVE CENTER PLLC
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2935
Practice Address - Country:US
Practice Address - Phone:713-512-7600
Practice Address - Fax:713-512-7873
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK7806207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1540122-01Medicaid
TX8F8262OtherBLUE CROSS & BLUE SHIELD
TX1540122-01Medicaid
TXH01841Medicare UPIN
TX8220B6Medicare PIN