Provider Demographics
NPI:1851304802
Name:CTOA LLC.
Entity Type:Organization
Organization Name:CTOA LLC.
Other - Org Name:CHILDRENS THERAPEUTICS OF AUSTIN
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GABRIELE
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:512-533-9313
Mailing Address - Street 1:3211 HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-5427
Mailing Address - Country:US
Mailing Address - Phone:512-533-9313
Mailing Address - Fax:512-533-9317
Practice Address - Street 1:3211 HANCOCK DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-5427
Practice Address - Country:US
Practice Address - Phone:512-533-9313
Practice Address - Fax:512-533-9317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0035JCOtherBCBS PROVIDER