Individual
TIFFANY A. COTHREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.A.
Contact information
Practice address
1500 CITYWEST BLVD, STE. 300, HOUSTON, TX 77042-2300
(713) 620-4000
(713) 458-4229
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
705
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348104601
—
TX
01
—
P00292002
RAILROAD MEDICARE
TX
01
—
P01466089
RR MEDICARE
TX
Enumeration date
01/17/2007
Last updated
02/25/2019
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