Provider Demographics
NPI:1851014369
Name:GARCIA, CLAUDIA ERIKA (COTA)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ERIKA
Last Name:GARCIA
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 1:409 W SUMMERKAMP ST
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-4402
Mailing Address - Country:US
Mailing Address - Phone:903-714-0725
Mailing Address - Fax:
Practice Address - Street 1:409 W SUMMERKAMP ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-4402
Practice Address - Country:US
Practice Address - Phone:903-714-0725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217582225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX09365413Medicaid