MEDICARE: GIOVANNA LOPEZ 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	209381	TX

General Provider Information

NPI Number	:	1588965669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIOVANNA LOPEZ COTA

Provider Business Mailing Address
First Line	:	16651 GREENBRIAR POINT LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-5550
Country	:	US
Telephone Number	:	347-645-6720
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 ENCLAVE PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-3671
Country	:	US
Telephone Number	:	281-531-1905
Fax Number	:

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

Provider Enumeration Date	:	11/05/2010
Last Update Date	:	11/05/2010

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