MEDICARE: ERIN MICHAL BARNES 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	211017	TX

General Provider Information

NPI Number	:	1992051353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN MICHAL BARNES COTA

Provider Business Mailing Address
First Line	:	211 CHEYENNE TRL N
Second Line	:
City	:	RHOME
State	:	TX
Zip	:	76078-5423
Country	:	US
Telephone Number	:	817-823-4991
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 ROBERTS CUT OFF RD
Second Line	:
City	:	RIVER OAKS
State	:	TX
Zip	:	76114-2825
Country	:	US
Telephone Number	:	817-823-4991
Fax Number	:

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

Provider Enumeration Date	:	08/02/2012
Last Update Date	:	08/02/2012

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