Healthcare Provider Details

I. General information

NPI: 1114350634
Provider Name (Legal Business Name): DEBBIE LUBIN COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2013
Last Update Date: 08/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 WINDSOR WAY
VAN ALSTYNE TX
75495-3626
US

IV. Provider business mailing address

1200 HYDE PARK DR
MCKINNEY TX
75069-5354
US

V. Phone/Fax

Practice location:
  • Phone: 903-482-6455
  • Fax:
Mailing address:
  • Phone: 786-651-1521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number211626
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: