NPIMap

Organization Active NPI

Central Texas Pain Center, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Georgetown, TX
National Provider Identifier
1396119178
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
J7566 Issued in TX
Legal business name
CENTRAL TEXAS PAIN CENTER, PLLC
Practice address
3201 S Austin Ave Ste 265
Georgetown, TX 78626-7641
Phone
(855) 876-7246
Fax
(855) 277-5070
NPI assigned
Nov 17, 2015
Last updated
Jul 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Authorized official

Name
Daniel FrederickNPI 1801973581
Title
MD/Authorized Officer
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X J7566 TX Primary

Addresses

Primary practice location

3201 S Austin Ave Ste 265
Georgetown, TX 78626-7641

Mailing address

PO Box 208357
Dallas, TX 75320-8357
Phone (512) 485-7208

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251118003299 TX DME Supplier - Multi-Specialty - Physician 0547233207 Practice locations: Georgetown, 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
Central TX Pain Center PLLC17 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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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": "1447718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752019200000",
    "number": "1396119178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208357",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753208357",
            "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": "3201 S AUSTIN AVE STE 265",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786267641",
            "telephone_number": "855-876-7246",
            "fax_number": "855-277-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS PAIN CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-17",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MD/AUTHORIZED OFFICER",
        "authorized_official_telephone_number": "512-485-7208"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "J7566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; 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.