Provider Demographics
NPI:1073602454
Name:KIDABILITIES PC
Entity Type:Organization
Organization Name:KIDABILITIES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED OCCUPATIONAL THERAPI
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:VERES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:512-930-5439
Mailing Address - Street 1:PO BOX 1585
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78627-1585
Mailing Address - Country:US
Mailing Address - Phone:512-930-5439
Mailing Address - Fax:512-930-5431
Practice Address - Street 1:1520 LEANDER ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628
Practice Address - Country:US
Practice Address - Phone:512-930-5439
Practice Address - Fax:512-930-5431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108156225XP0200X
TX543300000225XP0200X
TX113216225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty