MEDICARE: CHILDREN'S EVALUATION AND THERAPY CENTER

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
1	225XP0200X	Pediatric Occupational Therapist	509300000	TX

General Provider Information

NPI Number	:	1427212554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S EVALUATION AND THERAPY CENTER

Provider Business Mailing Address
First Line	:	12501 HYMEADOW DR
Second Line	:	SUITE F
City	:	AUSTIN
State	:	TX
Zip	:	78750-2263
Country	:	US
Telephone Number	:	512-331-5488
Fax Number	:	512-331-5489

Provider Business Practice Location Address
First Line	:	12501 HYMEADOW DR
Second Line	:	SUITE F
City	:	AUSTIN
State	:	TX
Zip	:	78750-2263
Country	:	US
Telephone Number	:	512-331-5488
Fax Number	:	512-331-5489

Authorized Official
Title or Position	:	THERAPIST/PARTNER
Name	:	MS. DIANNE HILL TANNREUTHER
Credential	:	MS, OTR
Telephone Number	:	512-331-5488

Provider Enumeration Date	:	07/17/2008
Last Update Date	:	07/17/2008

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