NPIMap

Organization Active NPI

Central Texas Medical Associates

  • Family Medicine Physician
  • San Marcos, TX
National Provider Identifier
1083679294
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0168 Issued in TX
Legal business name
CENTRAL TEXAS MEDICAL ASSOCIATES
Practice address
2005 Medical Pkwy
Suite C
San Marcos, TX 78666-7576
Phone
(512) 396-3911
Fax
(512) 353-0807
NPI assigned
Apr 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Debra Gay Eldridge
Title
Manager
Phone
(512) 353-0744

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X D0168 TX Primary

Addresses

Primary practice location

2005 Medical Pkwy
Suite C
San Marcos, TX 78666-7576

Mailing address

2005 Medical Pkwy
Suite C
San Marcos, TX 78666-7576
Phone (512) 753-3756

Other identifiers 1

IdentifierTypeStateIssuer
114603702MedicaidTX

National Provider Directory

National Provider Directory

Locations

2005 Medical Pkwy
Ste C
San Marcos, TX 78666
Phone (512) 396-3911

2005 Medical Pkwy
Ste A
San Marcos, TX 78666
Phone (512) 392-1180

950 Ranch Road 2325
Ste B
Wimberley, TX 78676
Phone (512) 847-3434

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310342400000",
    "number": "1083679294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 MEDICAL PKWY",
            "address_2": "SUITE C",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667576",
            "telephone_number": "512-753-3756",
            "fax_number": "512-353-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 MEDICAL PKWY",
            "address_2": "SUITE C",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667576",
            "telephone_number": "512-396-3911",
            "fax_number": "512-353-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2011-07-11",
        "status": "A",
        "authorized_official_last_name": "ELDRIDGE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "GAY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "512-353-0744",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "D0168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114603702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.