MEDICARE: BREANNA RICHARDS COTA/L

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	216511	TX

General Provider Information

NPI Number	:	1790630630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREANNA RICHARDS COTA/L

Provider Business Mailing Address
First Line	:	9135 OAK POINTE
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77707-4633
Country	:	US
Telephone Number	:	409-679-9959
Fax Number	:

Provider Business Practice Location Address
First Line	:	9135 OAK POINTE
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77707-4633
Country	:	US
Telephone Number	:	409-679-9959
Fax Number	:

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

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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Directions to “ BREANNA RICHARDS COTA/L” Practice Location

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