Provider Demographics
NPI:1013654409
Name:COTTER, SAVANNAH BRYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:SAVANNAH
Middle Name:BRYCE
Last Name:COTTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:JULE
Other - Last Name:BRYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:777 DUNLAVY ST APT 1308
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-1950
Mailing Address - Country:US
Mailing Address - Phone:713-471-8660
Mailing Address - Fax:
Practice Address - Street 1:777 DUNLAVY ST APT 1308
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-1950
Practice Address - Country:US
Practice Address - Phone:713-471-8660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10080834390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program