NPIMap

Organization Active NPI

Mid Tex Anesthesia Associates, PA

  • Anesthesiology Physician
  • Waco, TX
National Provider Identifier
1174612857
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MID TEX ANESTHESIA ASSOCIATES, PA
Practice address
405 Londonderry Dr
Suite 105
Waco, TX 76712-7920
Phone
(254) 776-0266
Fax
(254) 776-2511
NPI assigned
Oct 12, 2006
Last updated
May 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Authorized official

Name
Gay Lynn Kent
Title
Administrator
Phone
(254) 776-0266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

405 Londonderry Dr
Suite 105
Waco, TX 76712-7920

Mailing address

405 Londonderry Dr Ste 105
Waco, TX 76712-7920
Phone (254) 776-0266

Other identifiers 1

IdentifierTypeStateIssuer
098220902MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080603000130 TX Part B Supplier - Clinic/Group Practice 5395815369 Receives reassigned benefits from 31 practitioners
Practice locations: Waco, TX

National Provider Directory

National Provider Directory

Locations

405 Londonderry Dr
#10505
Waco, TX 76712
Phone (254) 776-0266

601 W State Highway 6
Ste 109
Waco, TX 76710
Phone (254) 751-9836

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1174612857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR STE 105",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127920",
            "telephone_number": "254-776-0266",
            "fax_number": "254-776-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR",
            "address_2": "SUITE 105",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127920",
            "telephone_number": "254-776-0266",
            "fax_number": "254-776-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID TEX ANESTHESIA ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A",
        "authorized_official_last_name": "KENT",
        "authorized_official_first_name": "GAY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "254-776-0266"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098220902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.