Bottenfield, Gerald W

Bottenfield, Gerald W is an sole proprietor health care provider with primary practice located at 210 Lake Rd Ste 600 , Lake Jackson TX 77566-4982. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bottenfield, Gerald W can be contacted via phone (979) 297-7337.

Contact Information

Primary practice address
210 Lake Rd Ste 600 Lake Jackson TX 77566-4982
Phone: (979) 297-7337
Fax: (979) 297-9096
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G4086 Texas

Profile Details

NPI number 1124084231
LBN Legal business name Bottenfield, Gerald W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 26th, 2006
Last updated Dec 19th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124084231 NPPES
Texas MEDICAID 121182303
Texas Other 82971Y
Texas MEDICAID 121182304

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