Provider Demographics
NPI:1275223422
Name:COATS, MAEGAN LYNN (COTA)
Entity Type:Individual
Prefix:
First Name:MAEGAN
Middle Name:LYNN
Last Name:COATS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 PRIVATE ROAD 5060
Mailing Address - Street 2:
Mailing Address - City:SAN AUGUSTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75972-4005
Mailing Address - Country:US
Mailing Address - Phone:936-201-2404
Mailing Address - Fax:
Practice Address - Street 1:134 PRIVATE ROAD 5060
Practice Address - Street 2:
Practice Address - City:SAN AUGUSTINE
Practice Address - State:TX
Practice Address - Zip Code:75972-4005
Practice Address - Country:US
Practice Address - Phone:936-201-2404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217477224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant