Healthcare Provider Details

I. General information

NPI: 1013991017
Provider Name (Legal Business Name): EASTER SEALS CENTRAL TEXAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 CENTRE PARK DR STE 130
AUSTIN TX
78754-5108
US

IV. Provider business mailing address

633 3RD AVE FL 6
NEW YORK NY
10017-6733
US

V. Phone/Fax

Practice location:
  • Phone: 512-615-6800
  • Fax: 512-615-7121
Mailing address:
  • Phone: 512-615-6800
  • Fax: 512-615-7121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: CAROL KHOURY
Title or Position: CFO
Credential:
Phone: 512-615-6800