Provider Demographics
NPI:1922300425
Name:AJ COTTINGHAM JR MD ,PLLC
Entity Type:Organization
Organization Name:AJ COTTINGHAM JR MD ,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALOMOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JACKSON
Authorized Official - Last Name:COTTINGHAM
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:210-696-0101
Mailing Address - Street 1:15900 LA CANTERA PKWY
Mailing Address - Street 2:SUITE 19205
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256
Mailing Address - Country:US
Mailing Address - Phone:210-696-0101
Mailing Address - Fax:210-695-8172
Practice Address - Street 1:15900 LA CANTERA PKWY
Practice Address - Street 2:SUITE 19205
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-2422
Practice Address - Country:US
Practice Address - Phone:210-696-0101
Practice Address - Fax:210-695-8172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7466207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty