Provider Demographics
NPI:1386830297
Name:VASQUEZ, NEIRA (COTA)
Entity Type:Individual
Prefix:MS
First Name:NEIRA
Middle Name:
Last Name:VASQUEZ
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 1:6020 N 36TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-5048
Mailing Address - Country:US
Mailing Address - Phone:956-631-6200
Mailing Address - Fax:956-631-6433
Practice Address - Street 1:4107 N 22ND ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4141
Practice Address - Country:US
Practice Address - Phone:956-631-6200
Practice Address - Fax:956-631-6433
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210002224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant