Healthcare Provider Details

I. General information

NPI: 1891423042
Provider Name (Legal Business Name): ISABEL ESQUIVEL COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2022
Last Update Date: 08/15/2022
Certification Date: 07/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 WOODROW BEAN
EL PASO TX
79924-3832
US

IV. Provider business mailing address

1393 GEORGE DIETER DR STE A
EL PASO TX
79936-7410
US

V. Phone/Fax

Practice location:
  • Phone: 915-206-4428
  • Fax:
Mailing address:
  • Phone: 915-342-8450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number212697
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: