Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | N4677 | TX |
Y | 207QS0010X | Family Doctor - Sports Medicine | N4677 | TX |
NPI | 1164679429 |
---|---|
Provider Name | Dr. Brittany Rochelle Potter |
First Address | Dallas, TX 75222-2093 |
Second Address | Cedar Hill, TX 75104-2117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2008 |
Last Update Date | 01/12/2017 |