MEDICARE: MS. MARTHA EILEEN WATSON 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	201184	TX

General Provider Information

NPI Number	:	1285889725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARTHA EILEEN WATSON COTA

Provider Business Mailing Address
First Line	:	1111 GOLFVIEW DR
Second Line	:	APT.#803
City	:	RICHMOND
State	:	TX
Zip	:	77469-5136
Country	:	US
Telephone Number	:	281-762-2429
Fax Number	:

Provider Business Practice Location Address
First Line	:	4225 DENMARK ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77016-6801
Country	:	US
Telephone Number	:	713-631-0200
Fax Number	:

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

Provider Enumeration Date	:	11/25/2008
Last Update Date	:	11/25/2008

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