Provider Demographics
NPI:1346819455
Name:COTTER, JASON CASH
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:CASH
Last Name:COTTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 LAUREL VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-4020
Mailing Address - Country:US
Mailing Address - Phone:817-723-6655
Mailing Address - Fax:
Practice Address - Street 1:2702 LAUREL VALLEY LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-4020
Practice Address - Country:US
Practice Address - Phone:817-723-6655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11292452251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics