Provider Demographics
NPI:1871626077
Name:MILESTONES CHILDREN'S THERAPY
Entity type:Organization
Organization Name:MILESTONES CHILDREN'S THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LESIEUR
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:512-260-3300
Mailing Address - Street 1:1490 E WHITESTONE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-2274
Mailing Address - Country:US
Mailing Address - Phone:512-260-3300
Mailing Address - Fax:512-260-3343
Practice Address - Street 1:1490 E WHITESTONE BLVD
Practice Address - Street 2:STE 100
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2274
Practice Address - Country:US
Practice Address - Phone:512-260-3300
Practice Address - Fax:512-260-3343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18312-1OtherPACIFICARE PROVIDER #
TX007OHVOtherBCBS PROVIDER #
TX7937419OtherAETNA PROVIDER #