Provider Demographics
NPI:1588142822
Name:DUNCAN, CARA JAN (COTA)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:JAN
Last Name:DUNCAN
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 1:326 COUNTY ROAD 3621
Mailing Address - Street 2:
Mailing Address - City:DIKE
Mailing Address - State:TX
Mailing Address - Zip Code:75437-4823
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1501 HOLIDAY DR
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-4707
Practice Address - Country:US
Practice Address - Phone:903-335-8727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212416224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant