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NPI Code Detail

MEDICARE: CHILDRENS OCCUPATIONAL, PHYSICAL, SPEECH THERAPY SERVICES, PLLC

MEDICARE: CHILDRENS OCCUPATIONAL, PHYSICAL, SPEECH THERAPY SERVICES, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251P0200XPediatric Physical TherapistTX

General Provider Information

NPI Number : 1902907868
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDRENS OCCUPATIONAL, PHYSICAL, SPEECH THERAPY SERVICES, PLLC
Provider Business Mailing Address
First Line : 9907 GRAND OAK DR
Second Line :
City : AUSTIN
State : TX
Zip : 78750-3819
Country : US
Telephone Number : 512-331-1999
Fax Number : 512-331-9199
Provider Business Practice Location Address
First Line : 6102 SPICEWOOD SPRINGS RD
Second Line :
City : AUSTIN
State : TX
Zip : 78759-7818
Country : US
Telephone Number : 512-331-1999
Fax Number : 512-331-9199
Authorized Official
Title or Position : PHYSICAL THERAPIST, OWNER
Name : JENNIFER YOUNG
Credential : PT
Telephone Number : 512-331-1999
Provider Enumeration Date : 09/25/2006
Last Update Date : 08/22/2020

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Directions to “CHILDRENS OCCUPATIONAL, PHYSICAL, SPEECH THERAPY SERVICES, PLLC ” Practice Location

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