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NPI Code Detail

MEDICARE: ERIN L NICHOLS COTA

MEDICARE: ERIN L NICHOLS 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 Assistant215805TX

General Provider Information

NPI Number : 1356993588
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN L NICHOLS COTA
Provider Business Mailing Address
First Line : 1836 SANTA FE DR
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-6422
Country : US
Telephone Number : 817-341-7611
Fax Number : 817-599-7655
Provider Business Practice Location Address
First Line : 1836 SANTA FE DR
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-6422
Country : US
Telephone Number : 817-341-7611
Fax Number : 817-599-7655
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2019
Last Update Date : 07/09/2019

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Directions to “ ERIN L NICHOLS COTA” Practice Location

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