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NPI Code Detail

MEDICARE: KAREN LEA CRAWFORD COTA

MEDICARE: KAREN LEA CRAWFORD 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
1314000000XSkilled Nursing Facility209430TX

General Provider Information

NPI Number : 1619171675
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN LEA CRAWFORD COTA
Provider Business Mailing Address
First Line : 2020 MIMOSA DR
Second Line :
City : CORSICANA
State : TX
Zip : 75110-2026
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3301 W PARK ROW BLVD
Second Line :
City : CORSICANA
State : TX
Zip : 75110-4846
Country : US
Telephone Number : 903-874-5238
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 07/08/2007

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