MEDICARE: MRS. DIANE LLOYD COTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	210686	TX

General Provider Information

NPI Number	:	1104246347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DIANE LLOYD COTA

Provider Business Mailing Address
First Line	:	3120 SOUTHWEST FWY STE 612
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-4521
Country	:	US
Telephone Number	:	713-979-3800
Fax Number	:	713-979-3806

Provider Business Practice Location Address
First Line	:	3120 SOUTHWEST FWY STE 612
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-4521
Country	:	US
Telephone Number	:	713-979-3800
Fax Number	:	713-979-3806

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2014
Last Update Date	:	04/25/2014

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