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General NPI Number Information
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NPI Number | 1861971491
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Entity Type | Individual
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Provider Name | NIKKI MARIE ZAVALA COTA
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Gender | Female
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Dates
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Enumeration Date | 08/14/2018
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Last Update Date | 06/09/2023
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Provider Practice Location Address
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Address Line | 1814 ATRIUM PLACE DR
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City | HARLINGEN
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State | TX
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Zip | 78550-2583
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Country | US
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Telephone | 956-230-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 941 E GEM AVE
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City | RAYMONDVILLE
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State | TX
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Zip | 78580-4120
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Country | US
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Telephone | 956-966-7519
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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 | 212857
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License Number State | TX
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