=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174965941
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARBARA BYRD COTA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2013
-----------------------------------------------------
Last Update Date | 08/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 461 E 146TH ST S
-----------------------------------------------------
City | GLENPOOL
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74033-3900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-322-9500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1712 W 120TH ST S
-----------------------------------------------------
City | JENKS
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74037-2978
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-605-4916
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 224Z00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapy Assistant
-----------------------------------------------------
License Number | 0A73
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------