GERALD W BOTTENFIELD (NPI# 1124084231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124084231 |
| Entity Type | Individual |
| Full Name | GERALD W BOTTENFIELD |
| Credential | M.D. |
| Practice Address |
210 Lake Rd Ste 600 Lake Jackson TX 77566-4982 |
| Practice Telephone | 9792977337 |
| Practice Fax Number | 9792979096 |
| Mailing Telephone | 9792977337 |
| Mailing Fax Number | 9792669076 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2019-12-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | G4086 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 121182303 | 05 | |
| TX | BLUE CROSS BLUE SHIELD | 82971Y | 01 |
| TX | 121182304 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 207 That Way St # A-1, Lake Jackson, TX 775665211 | 9792977337 |
| Street Address |
210 LAKE RD STE 600 |
| City | LAKE JACKSON |
| State | TX |
| Zip Code | 77566-4982 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316474661 | Kalyn Michelle Collard | Pediatrics | 210 Lake Rd Ste 600, Lake Jackson, TX 77566-4982 | 2017-05-17 |
| 1972685113 | Lucinda Monica Henry | Physician Assistant | 210 Lake Rd Ste 600, Lake Jackson, TX 77566-4982 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588271746 | Daniel Kent | Pharmacist | 121 Tx-332 W, Lake Jackson, TX 77566 | 2020-09-30 |
| 1134692403 | Gulf Coast Gastroenterology Lab | Clinical Medical Laboratory | 219 Oak Drive South, Suite A, Lake Jackson, TX 77566 | 2019-01-09 |
| 1194266288 | Kaitlin Dingee | Nurse Practitioner | 208 Oak Dr S Ste 502, Lake Jackson, TX 77566 | 2017-03-09 |
| 1326581935 | Nec Lake Jackson Emergency Center, Lp | Clinic/Center | 103 Winding Way, Lake Jackson, TX 77566 | 2016-11-30 |
| 1548618911 | Sara Eddy | Counselor | 109 Circle Way, Lake Jackson, TX 77566 | 2016-05-26 |
| 1689020158 | Baker Chiropractic Center Pllc | Chiropractor | 100-a Plantation Drive, Lake Jackson, TX 77566 | 2016-05-13 |
| 1326409368 | Janet Chen | Pharmacist | 131 Oyster Creek Dr., Lake Jackson, TX 77566 | 2016-03-18 |
| 1164819488 | Eco Dental Care, Pllc | Dentist | 210 Lake Rd, Ste 800 A, Lake Jackson, TX 77566 | 2015-04-24 |
| 1730578196 | Anna Katherine Tucker | Occupational Therapy Assistant | 1052 Cardinal Dr, Richwood, TX 77566 | 2015-01-22 |
| 1306243035 | H-e-b, Lp | Clinical Medical Laboratory | 97 Oyster Creek Drive, Lake Jackson, TX 77566 | 2014-11-24 |
| Find all providers in zip 77566 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114525532 | Springs Pediatrics Associates Pllc | Pediatrics | 201 Oak Dr S Ste 202, Lake Jackson, TX 77566-5627 | 2020-10-16 |
| 1710540513 | Bottenfield Pediatric Associates, Pllc | Pediatrics | 210 Lake Rd Bldg 600, Lake Jackson, TX 77566-4982 | 2019-04-17 |
| 1427411552 | Lee Bostick Elam | Pediatrics | 208 Oak Dr S Ste 400a, Lake Jackson, TX 77566-5640 | 2016-04-05 |
| 1194100941 | Alan Douglas Strickland | Pediatrics | 101 Waterlily St, Lake Jackson, TX 77566-5055 | 2015-07-22 |
| 1144454026 | Sreekar Maruvada | Pediatrics | 210 Lake Rd Ste 800b, Lake Jackson, TX 77566 | 2009-05-07 |
| 1598815896 | Kathleen E Sommers | Pediatrics | 115 Abner Jackson Pkwy Ste C, Lake Jackson, TX 77566-5157 | 2007-01-11 |
| 1831104702 | Iso-3, L.L.C. | Pediatrics | 122 W Way St, Suite 406, Lake Jackson, TX 77566-5225 | 2006-07-29 |
| 1518923440 | Richard A Hardoin | Pediatrics | 54 Flag Lake Plz, Lake Jackson, TX 77566-6263 | 2006-04-20 |
| 1316474661 | Kalyn Michelle Collard | Pediatrics | 210 Lake Rd Ste 600, Lake Jackson, TX 77566-4982 | 2017-05-17 |
| 1073704268 | Loni Lynn Shepherd | Pediatrics | 208 Oak Dr S, Suite 400, Lake Jackson, TX 77566-5790 | 2007-08-05 |
| Find all providers in LAKE JACKSON | ||||
| City | LAKE JACKSON |
| Zip Code | 77566 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.