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General NPI Number Information
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NPI Number | 1053911560
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Entity Type | Individual
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Provider Name | CARA BOWLES COTA
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Gender | Female
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Dates
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Enumeration Date | 10/26/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 404 RACQUET CLUB BLVD
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City | BEDFORD
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State | TX
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Zip | 76022-6408
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Country | US
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Telephone | 682-738-3056
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Fax |
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Provider Business Mailing Address
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Address Line | 2607 LOCKSLEY CHASE
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City | IRVING
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State | TX
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Zip | 75061-6405
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Country | US
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Telephone | 214-952-2775
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 443098
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License Number State | TX
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