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NPI Code Detail

MEDICARE: ALYSE ROSEANN ACOSTA COTA

MEDICARE: ALYSE ROSEANN ACOSTA 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 Assistant217339TX

General Provider Information

NPI Number : 1366174153
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSE ROSEANN ACOSTA COTA
Provider Business Mailing Address
First Line : 9220 KIRBY DR STE 1000
Second Line :
City : HOUSTON
State : TX
Zip : 77054-2534
Country : US
Telephone Number : 713-383-9700
Fax Number :
Provider Business Practice Location Address
First Line : 1351 E BARDIN RD STE 160
Second Line :
City : ARLINGTON
State : TX
Zip : 76018-2137
Country : US
Telephone Number : 817-795-1291
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2022
Last Update Date : 06/29/2022

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Directions to “ ALYSE ROSEANN ACOSTA COTA” Practice Location

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