Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | K7806 | TX |
NPI | 1639171903 |
---|---|
Provider Name | Peter M Lotze |
First Address | Houston, TX 77054-2935 |
Second Address | Houston, TX 77054-2935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 03/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1540122-01 | (05) | TX |
8F8262 | BLUE CROSS & BLUE SHIELD (01) | TX |
H01841 | (02) | TX |