NPIMap

Organization Active NPI

Central Texas Pain Center, PLLC

  • Durable Medical Equipment & Medical Supplies
  • San Marcos, TX
National Provider Identifier
1154823201
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
CENTRAL TEXAS PAIN CENTER, PLLC
Practice address
1304 Wonder World Dr
San Marcos, TX 78666-7532
Phone
(512) 498-1029
Fax
(888) 972-1190
NPI assigned
Mar 5, 2018
Last updated
Sep 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Authorized official

Name
Dr. Daniel Frederick, MDNPI 1801973581
Title
MD/Owner
Phone
(512) 485-7208

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X
Durable Medical Equipment & Medical Supplies 332B00000X L9364 TX
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1304 Wonder World Dr
San Marcos, TX 78666-7532

Mailing address

PO Box 208354
Dallas, TX 75320-8354
Phone (512) 485-7208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180629000321 TX DME Supplier - Physician - AnesthesiologyDME Supplier - Multi-Specialty - Physician 0547233207 Practice locations: San Marcos, TX

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Eric James Miller MD PA17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1154823201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208354",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753208354",
            "telephone_number": "512-485-7208",
            "fax_number": "844-364-8678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 WONDER WORLD DR",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667532",
            "telephone_number": "512-498-1029",
            "fax_number": "888-972-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS PAIN CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-05",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "512-485-7208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "L9364",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.