Provider Demographics
NPI:1962666842
Name:KOTTO-KOME, ANNE C (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:C
Last Name:KOTTO-KOME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 E PRESIDENT GEAORGE BUSH TURNPIKE, STE 250
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082
Mailing Address - Country:US
Mailing Address - Phone:888-822-2855
Mailing Address - Fax:
Practice Address - Street 1:2001 N OREGON ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3320
Practice Address - Country:US
Practice Address - Phone:915-542-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2011-04952080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine