Provider Demographics
NPI:1104345198
Name:COTTINGHAM, RODNEY
Entity type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:
Last Name:COTTINGHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 BAYTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7691
Mailing Address - Country:US
Mailing Address - Phone:972-971-9986
Mailing Address - Fax:
Practice Address - Street 1:1324 BAYTHORNE DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-7691
Practice Address - Country:US
Practice Address - Phone:972-971-9986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXFBX3310343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)