MEDICARE: CHERYL PHILLIPS CARLING 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	207924	TX

General Provider Information

NPI Number	:	1962611798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL PHILLIPS CARLING COTA

Provider Business Mailing Address
First Line	:	9810 SAGEMOSS LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-4225
Country	:	US
Telephone Number	:	832-243-6744
Fax Number	:

Provider Business Practice Location Address
First Line	:	9810 SAGEMOSS LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-4225
Country	:	US
Telephone Number	:	832-243-6744
Fax Number	:

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	07/08/2007

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