Organization Active NPI

Central Texas Orthopedic Surgery,P.a.

  • Orthopaedic Surgery Physician
  • Brownwood, TX
National Provider Identifier
1619078920
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
J6662 Issued in TX
Legal business name
CENTRAL TEXAS ORTHOPEDIC SURGERY,P.A.
Practice address
2510 Crockett Dr
Suite a
Brownwood, TX 76801-5928
Phone
(325) 643-5513
NPI assigned
Sep 26, 2006
Last updated
Jul 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Authorized official

Name
Mrs. Crescent L Clark
Title
Manager
Phone
(325) 643-5513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X J6662 TX Primary

Addresses

Primary practice location

2510 Crockett Dr
Suite a
Brownwood, TX 76801-5928

Mailing address

2510 Crockett Dr
Suite a
Brownwood, TX 76801-5928
Phone (325) 643-5513

Other identifiers 5

IdentifierTypeStateIssuer
127632105MedicaidTX
181622100OtherTXDEPT OF LABOR
8X1180OtherTXBLUE CROSS BLUE SHIELD TX
0040AVOtherTXBLUE CROSS BLUE SHIELD TX
119756OtherTXSUPERIOR HEALTH PLAN

National Provider Directory

National Provider Directory

Locations

2510 Crockett Dr
Ste A
Brownwood, TX 76801
Phone (325) 643-5513

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": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1619078920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 CROCKETT DR",
            "address_2": "SUITE A",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768015928",
            "telephone_number": "325-643-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 CROCKETT DR",
            "address_2": "SUITE A",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768015928",
            "telephone_number": "325-643-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS ORTHOPEDIC SURGERY,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CRESCENT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "325-643-5513",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "J6662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127632105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "181622100",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TX",
            "identifier": "8X1180",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TX",
            "identifier": "0040AV",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR HEALTH PLAN",
            "identifier": "119756",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.