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General NPI Number Information
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NPI Number | 1780853374
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Entity Type | Individual
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Provider Name | HERENDIDA G FLORES COTA
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Gender | Female
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 1900 REBECCA STREET
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City | MISSION
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State | TX
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Zip | 78572
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Country | US
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Telephone | 956-519-8525
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Fax |
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Provider Business Mailing Address
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Address Line | 202 E EXPRESSWAY 83 SUITE D
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City | MISSION
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State | TX
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Zip | 78572-6020
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Country | US
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Telephone | 956-585-3333
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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 | 209395
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License Number State | TX
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