Provider Demographics
NPI:1154468254
Name:VERES, CHRISTINE CAROL (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CAROL
Last Name:VERES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108156225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89985TOtherBCBS PROVIDER NUMBER