MEDICARE: ALISHA MOTTA

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	164W00000X	Licensed Practical Nurse	PN283699	PA

General Provider Information

NPI Number	:	1164701413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISHA MOTTA

Provider Business Mailing Address
First Line	:	539 W COMMERCE ST # 7044
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-1953
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	539 W COMMERCE ST # 7044
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-1953
Country	:	US
Telephone Number	:	999-999-9999
Fax Number	:

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

Provider Enumeration Date	:	08/04/2011
Last Update Date	:	02/11/2026

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Directions to “ ALISHA MOTTA ” Practice Location

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