MEDICARE: JOY ANN JOHNSON 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	208979	TX

General Provider Information

NPI Number	:	1982880852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY ANN JOHNSON COTA

Provider Business Mailing Address
First Line	:	2425 BAHAMA DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75211-2018
Country	:	US
Telephone Number	:	214-941-3811
Fax Number	:

Provider Business Practice Location Address
First Line	:	2425 BAHAMA DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75211-2018
Country	:	US
Telephone Number	:	214-941-3811
Fax Number	:

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

Provider Enumeration Date	:	01/10/2008
Last Update Date	:	01/10/2008

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