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General NPI Number Information
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NPI Number | 1306234570
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Entity Type | Individual
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Provider Name | KEVIN FLOYD COTA/L
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Gender | Male
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 12/22/2014
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Provider Practice Location Address
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Address Line | 5034 NEWFOREST DRIVE #8309
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 601-606-5482
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Fax |
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Provider Business Mailing Address
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Address Line | 5565 MANSIONS BLFS 1207
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City | SAN ANTONIO
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State | TX
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Zip | 78245-4129
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Country | US
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Telephone |
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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 | 212910
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License Number State | TX
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