MEDICARE: MARYBETH COATES PTA

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	225200000X	Physical Therapy Assistant	2072371	TX

General Provider Information

NPI Number	:	1306105648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYBETH COATES PTA

Provider Business Mailing Address
First Line	:	16240 SEAHORSE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77062-6216
Country	:	US
Telephone Number	:	281-892-9051
Fax Number	:

Provider Business Practice Location Address
First Line	:	16240 SEAHORSE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77062-6216
Country	:	US
Telephone Number	:	281-892-9051
Fax Number	:

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

Provider Enumeration Date	:	05/07/2012
Last Update Date	:	05/07/2012

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Directions to “ MARYBETH COATES PTA” Practice Location

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