NPIMap

Organization Active NPI

Central Texas Pain Center South PLLC

  • Interventional Pain Medicine Physician
  • San Antonio, TX
National Provider Identifier
1821341355
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
L9364 Issued in TX
Legal business name
CENTRAL TEXAS PAIN CENTER SOUTH PLLC
Practice address
250 E Basse Rd Ste 207
San Antonio, TX 78209-8409
Phone
(210) 614-9955
Fax
(210) 614-9966
NPI assigned
Oct 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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 connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X L9364 TX Primary

Addresses

Primary practice location

250 E Basse Rd Ste 207
San Antonio, TX 78209-8409

Mailing address

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

National Provider Directory

National Provider Directory

Locations

7201 Wyoming Springs Dr
Ste 400
Round Rock, TX 78681
Phone (512) 953-8133

4410 Medical Dr
Ste 390
San Antonio, TX 78229
Phone (210) 614-9955

Practitioners & affiliated clinicians

Practitioners 5

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": "1350864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1821341355",
    "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": "250 E BASSE RD STE 207",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782098409",
            "telephone_number": "210-614-9955",
            "fax_number": "210-614-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS PAIN CENTER SOUTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-22",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "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": "TX",
            "license": "L9364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.