Provider Demographics
NPI:1659091817
Name:TENA, PEDRO L (COTA/L)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:L
Last Name:TENA
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:PEDRO
Other - Middle Name:
Other - Last Name:TENA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA/L
Mailing Address - Street 1:1221 URBANA RD
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-8703
Mailing Address - Country:US
Mailing Address - Phone:870-315-9427
Mailing Address - Fax:
Practice Address - Street 1:1001 TOWSON AVE FL 6
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-4921
Practice Address - Country:US
Practice Address - Phone:479-441-3980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A1693224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant