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General NPI Number Information
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NPI Number | 1912038555
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Entity Type | Individual
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Provider Name | JULIA L MOON COTA,L
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10300 W 103RD ST SUITE 300
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City | OVERLAND PARK
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State | KS
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Zip | 66214-2642
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Country | US
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Telephone | 913-894-1910
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Fax |
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Provider Business Mailing Address
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Address Line | 4435 W 152ND CT
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City | LEAWOOD
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State | KS
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Zip | 66224-9782
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 18-00225
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2002030254
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License Number State | MO
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