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General NPI Number Information
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NPI Number | 1962607408
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Entity Type | Individual
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Provider Name | SHERI SHIRLEY COTA
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Gender | Female
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 3200 TROUP HWY STE. 120
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City | TYLER
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State | TX
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Zip | 75701-8397
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Country | US
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Telephone | 903-721-0815
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Fax |
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Provider Business Mailing Address
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Address Line | 551 FM 1248 S
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City | RUSK
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State | TX
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Zip | 75785-5226
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 208634
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License Number State | TX
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