MEDICARE: ROBIN WATSON 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
1	224Z00000X	Occupational Therapy Assistant	206713	TX

General Provider Information

NPI Number	:	1386067148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN WATSON COTA

Provider Business Mailing Address
First Line	:	1030 STORY BOOK LN
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-5384
Country	:	US
Telephone Number	:	940-389-1669
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 HOLLAND LAKE DR
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-5851
Country	:	US
Telephone Number	:	817-598-0160
Fax Number	:

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

Provider Enumeration Date	:	01/30/2014
Last Update Date	:	01/30/2014

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