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NPI Code Detail

MEDICARE: VICTORIA R TEETS COTA

MEDICARE:   VICTORIA R TEETS  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 Assistant210807TX
2224Z00000XOccupational Therapy AssistantOTA001548GA

General Provider Information

NPI Number : 1841566197
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA R TEETS COTA
Provider Business Mailing Address
First Line : 3100 SAVANNAH HWY
Second Line :
City : JESUP
State : GA
Zip : 31545-2149
Country : US
Telephone Number : 832-880-6342
Fax Number :
Provider Business Practice Location Address
First Line : 2100 WEST LOOP S STE 1525
Second Line :
City : HOUSTON
State : TX
Zip : 77027-3508
Country : US
Telephone Number : 713-965-9998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2012
Last Update Date : 10/11/2016

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Directions to “ VICTORIA R TEETS COTA” Practice Location

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