Healthcare Provider Details

I. General information

NPI: 1144133075
Provider Name (Legal Business Name): ASHLEY CHAMPAGNE COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 NEW TRAILS DR STE 115
SPRING TX
77381-4241
US

IV. Provider business mailing address

1720 SUMMIT CROSSING LN APT 4108
COLLEGE STATION TX
77845-0016
US

V. Phone/Fax

Practice location:
  • Phone: 281-290-4411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number217733
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: