Organization Active NPI

Central Texas Ambulatory Endoscopy Center

  • Endoscopy Clinic/Center
  • San Marcos, TX
National Provider Identifier
1720072457
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
License
000385 Issued in TX
Legal business name
CENTRAL TEXAS AMBULATORY ENDOSCOPY CENTER
Practice address
1305 Wonder World Dr
Suite 105
San Marcos, TX 78666-7546
Phone
(512) 754-8676
Fax
(512) 754-8680
NPI assigned
Sep 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Mrs. Bonnie Lynn Anders
Title
Administrative Asst.
Phone
(512) 754-8676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X 000385 TX Primary

Addresses

Primary practice location

1305 Wonder World Dr
Suite 105
San Marcos, TX 78666-7546

Mailing address

1305 Wonder World Dr
Suite 105
San Marcos, TX 78666-7546
Phone (512) 754-8676

Other identifiers 1

IdentifierTypeStateIssuer
087945401MedicaidTX

National Provider Directory

National Provider Directory

Locations

1305 Wonder World Dr
Ste 105
San Marcos, TX 78666
Phone (512) 353-8161

Practitioners & affiliated clinicians

Practitioners 1

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": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1720072457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 WONDER WORLD DR",
            "address_2": "SUITE 105",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667546",
            "telephone_number": "512-754-8676",
            "fax_number": "512-754-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 WONDER WORLD DR",
            "address_2": "SUITE 105",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667546",
            "telephone_number": "512-754-8676",
            "fax_number": "512-754-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS AMBULATORY ENDOSCOPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "ANDERS",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASST.",
        "authorized_official_telephone_number": "512-754-8676",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "TX",
            "license": "000385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087945401",
            "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 Oct 17, 2007; 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.