MEDICARE: MS. CHRISTINE MARIE GAHARAN OTR/L

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	107696	TX

General Provider Information

NPI Number	:	1457433096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINE MARIE GAHARAN OTR/L

Provider Business Mailing Address
First Line	:	4111 PASEO DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78739-4346
Country	:	US
Telephone Number	:	512-233-4000
Fax Number	:	512-233-4001

Provider Business Practice Location Address
First Line	:	2301 RIDDLE ROAD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748
Country	:	US
Telephone Number	:	512-233-4000
Fax Number	:	512-233-4001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	02/21/2017

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