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General NPI Number Information
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NPI Number | 1831863083
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Entity Type | Individual
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Provider Name | DENISE RUTH DAVIS COTA
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 4600 TAFT BLVD
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City | WICHITA FALLS
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State | TX
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Zip | 76308-4935
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Country | US
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Telephone | 940-691-1710
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Fax |
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Provider Business Mailing Address
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Address Line | 204 WISHBONE LN
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City | HASLET
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State | TX
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Zip | 76052-2094
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Country | US
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Telephone | 832-274-0413
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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 | 210665
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License Number State | TX
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