Provider Demographics
NPI:1841271681
Name:COTTON, CHRISTOPHER D (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:D
Last Name:COTTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 N AVENUE F
Mailing Address - Street 2:
Mailing Address - City:DENVER CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79323-2741
Mailing Address - Country:US
Mailing Address - Phone:806-592-9501
Mailing Address - Fax:806-592-3052
Practice Address - Street 1:415 N AVENUE F
Practice Address - Street 2:
Practice Address - City:DENVER CITY
Practice Address - State:TX
Practice Address - Zip Code:79323-2741
Practice Address - Country:US
Practice Address - Phone:806-592-9501
Practice Address - Fax:806-592-3052
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8227208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0082EVOtherBLUE CROSS/BLUE SHIELD
TX137227810Medicaid
G01374Medicare UPIN
TX137227810Medicaid