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NPI Code Detail

MEDICARE: MS. MACEY MARIE CHISHOLM-HANKS COTA

MEDICARE: MS. MACEY MARIE CHISHOLM-HANKS 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
1224Z00000XOccupational Therapy Assistant213522TX

General Provider Information

NPI Number : 1124509385
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MACEY MARIE CHISHOLM-HANKS COTA
Provider Business Mailing Address
First Line : 2102 PAPOOSE TRL
Second Line :
City : CROSBY
State : TX
Zip : 77532-3218
Country : US
Telephone Number : 832-509-9488
Fax Number :
Provider Business Practice Location Address
First Line : 310 E LAWRENCE ST
Second Line :
City : DAYTON
State : TX
Zip : 77535-1805
Country : US
Telephone Number : 936-258-7227
Fax Number : 936-258-7223
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2018
Last Update Date : 08/27/2018

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