Provider Demographics
NPI:1801882923
Name:LOTAN, DAN (MD)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:
Last Name:LOTAN
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 1:40 CYPRESS CREEK PKWY
Mailing Address - Street 2:STE 137
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3530
Mailing Address - Country:US
Mailing Address - Phone:832-476-3900
Mailing Address - Fax:
Practice Address - Street 1:2000 CRAWFORD
Practice Address - Street 2:SUITE 1350
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-9008
Practice Address - Country:US
Practice Address - Phone:713-650-0344
Practice Address - Fax:713-522-8271
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5442207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160458901Medicaid
TX1604589-02Medicaid
TX160458901Medicaid
8A9566Medicare ID - Type Unspecified
TX8L3917Medicare PIN