Provider Demographics
NPI:1386455079
Name:LOPEZ, MARIA FERNANDA (COTA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:FERNANDA
Last Name:LOPEZ
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 1:3110 N ESCOBARES LOOP APT 7
Mailing Address - Street 2:
Mailing Address - City:ROMA
Mailing Address - State:TX
Mailing Address - Zip Code:78584-6663
Mailing Address - Country:US
Mailing Address - Phone:956-400-9667
Mailing Address - Fax:
Practice Address - Street 1:3110 N ESCOBARES LOOP APT 7
Practice Address - Street 2:
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584-6663
Practice Address - Country:US
Practice Address - Phone:956-400-9667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218626224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant