MEDICARE: JUAN E. PEREZ COTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist
2	225X00000X	Occupational Therapist	121433	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104092121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN E. PEREZ COTA

Provider Business Mailing Address
First Line	:	102 PALO ALTO RD STE 120
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78211-3773
Country	:	US
Telephone Number	:	210-922-1785
Fax Number	:	210-922-1782

Provider Business Practice Location Address
First Line	:	102 PALO ALTO RD STE 120
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78211-3773
Country	:	US
Telephone Number	:	210-922-1785
Fax Number	:	210-922-1782

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2008
Last Update Date	:	08/19/2025

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Directions to “ JUAN E. PEREZ COTA” Practice Location

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