Provider Demographics
NPI:1568668283
Name:EASTER SEALS CENTRAL TEXAS, INC.
Entity Type:Organization
Organization Name:EASTER SEALS CENTRAL TEXAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:MIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-615-6811
Mailing Address - Street 1:8505 CROSS PARK DR STE 120
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-4552
Mailing Address - Country:US
Mailing Address - Phone:512-615-6800
Mailing Address - Fax:
Practice Address - Street 1:8505 CROSS PARK DR STE 120
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754
Practice Address - Country:US
Practice Address - Phone:512-615-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1169065251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services