MEDICARE: LINDA G. ALLARD 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	208471	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	224Z00000	OTHER	TX	OCCUPATIONAL THERAPY
2	10697192	OTHER	TX	OCCUPATIONAL THERAPY

General Provider Information

NPI Number	:	1750855854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA G. ALLARD COTA

Provider Business Mailing Address
First Line	:	1401 EAGLE LAKE RD
Second Line	:
City	:	SEALY
State	:	TX
Zip	:	77474-3109
Country	:	US
Telephone Number	:	979-885-2937
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 EAGLE LAKE RD
Second Line	:
City	:	SEALY
State	:	TX
Zip	:	77474-3109
Country	:	US
Telephone Number	:	979-885-2937
Fax Number	:

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

Provider Enumeration Date	:	01/11/2019
Last Update Date	:	01/11/2019

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