Provider Demographics
NPI:1841476272
Name:KIDS CHOICE P.A.
Entity type:Organization
Organization Name:KIDS CHOICE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:BEATRIZ
Authorized Official - Last Name:ABREU-MACOMBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-252-9611
Mailing Address - Street 1:2113 WELLS BRANCH PKWY
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-6970
Mailing Address - Country:US
Mailing Address - Phone:512-252-9611
Mailing Address - Fax:512-252-3036
Practice Address - Street 1:2113 WELLS BRANCH PKWY
Practice Address - Street 2:SUITE 1200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-6970
Practice Address - Country:US
Practice Address - Phone:512-252-9611
Practice Address - Fax:512-252-3036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5530261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care