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General NPI Number Information
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NPI Number | 1831679182
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Entity Type | Individual
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Provider Name | JOSUE PERALEZ COTA
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Gender | Male
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Dates
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Enumeration Date | 08/16/2018
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Last Update Date | 08/16/2018
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Provider Practice Location Address
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Address Line | 4430 E 14TH ST UNIT E BROWNSVILLE, TX 78521
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City | BROWNSVILLE
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State | TX
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Zip | 78521
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Country | US
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Telephone | 956-542-6296
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Fax |
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Provider Business Mailing Address
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Address Line | 2105 S ARDEN ST
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City | HARLINGEN
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State | TX
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Zip | 78552-7459
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Country | US
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Telephone | 956-456-2034
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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 | 215211
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License Number State | TX
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