Provider Demographics
NPI:1215989827
Name:COTTRELL, CHRISTOPHER JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:COTTRELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 STATE HIGHWAY 121 STE 120
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2902
Mailing Address - Country:US
Mailing Address - Phone:972-439-3753
Mailing Address - Fax:972-439-3754
Practice Address - Street 1:8080 STATE HIGHWAY 121 STE 120
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2902
Practice Address - Country:US
Practice Address - Phone:972-439-3753
Practice Address - Fax:972-439-3754
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2294208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178591701Medicaid
TX8U7651OtherBLUE CROSS BLUE SHIELD
TX8G1351Medicare ID - Type UnspecifiedMEDICARE NUMBER