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NPI Code Detail

MEDICARE: ABBEY RAE WADZECK-AREVALO COTA

MEDICARE: ABBEY RAE WADZECK-AREVALO 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
1224Z00000XOccupational Therapy Assistant214099TX

General Provider Information

NPI Number : 1649750522
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABBEY RAE WADZECK-AREVALO COTA
Provider Business Mailing Address
First Line : 316 GENERAL CAVAZOS BLVD
Second Line :
City : KINGSVILLE
State : TX
Zip : 78363-7245
Country : US
Telephone Number : 361-592-9366
Fax Number :
Provider Business Practice Location Address
First Line : 316 GENERAL CAVAZOS BLVD
Second Line :
City : KINGSVILLE
State : TX
Zip : 78363-7245
Country : US
Telephone Number : 361-592-9366
Fax Number : 361-595-7389
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2018
Last Update Date : 08/20/2018

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Directions to “ ABBEY RAE WADZECK-AREVALO COTA” Practice Location

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