Healthcare Provider Details

I. General information

NPI: 1932579166
Provider Name (Legal Business Name): BOBI FAOUR COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 N ED CAREY DR
HARLINGEN TX
78550-7914
US

IV. Provider business mailing address

2236 NYSSA AVE
MCALLEN TX
78501-6727
US

V. Phone/Fax

Practice location:
  • Phone: 956-440-1155
  • Fax:
Mailing address:
  • Phone: 956-330-3852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number213364
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: