Provider Demographics
NPI:1962981969
Name:FALCON, YESENIA (COTA)
Entity type:Individual
Prefix:MRS
First Name:YESENIA
Middle Name:
Last Name:FALCON
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 1:3800 S L ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1746
Mailing Address - Country:US
Mailing Address - Phone:956-537-7829
Mailing Address - Fax:
Practice Address - Street 1:2904 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1870
Practice Address - Country:US
Practice Address - Phone:956-631-8646
Practice Address - Fax:956-631-8650
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208949224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant