MEDICARE: MILESTONES CHILDREN'S THERAPY

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	261QP2000X	Physical Therapy Clinic/Center		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	18312-1	OTHER	TX	PACIFICARE PROVIDER #
2	007OHV	OTHER	TX	BCBS PROVIDER #
3	7937419	OTHER	TX	AETNA PROVIDER #

General Provider Information

NPI Number	:	1871626077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILESTONES CHILDREN'S THERAPY

Provider Business Mailing Address
First Line	:	1490 E WHITESTONE BLVD
Second Line	:	STE 100
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-2274
Country	:	US
Telephone Number	:	512-260-3300
Fax Number	:	512-260-3343

Provider Business Practice Location Address
First Line	:	1490 E WHITESTONE BLVD
Second Line	:	STE 100
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-2274
Country	:	US
Telephone Number	:	512-260-3300
Fax Number	:	512-260-3343

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST-OWNER
Name	:	STACEY LESIEUR
Credential	:	MS CCC SLP
Telephone Number	:	512-260-3300

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	08/22/2020

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Directions to “MILESTONES CHILDREN'S THERAPY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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