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NPI Code Detail

MEDICARE: DEBORAH KENNEMER COTA

MEDICARE: DEBORAH KENNEMER 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 Assistant208151TX

General Provider Information

NPI Number : 1710623467
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH KENNEMER COTA
Provider Business Mailing Address
First Line : 309 PLANTATION DR
Second Line :
City : LAKE JACKSON
State : TX
Zip : 77566-6142
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 309 PLANTATION DR
Second Line :
City : LAKE JACKSON
State : TX
Zip : 77566-6142
Country : US
Telephone Number : 979-418-7165
Fax Number : 800-419-5153
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2022
Last Update Date : 05/06/2022

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Directions to “ DEBORAH KENNEMER COTA” Practice Location

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