Healthcare Provider Details

I. General information

NPI: 1992620249
Provider Name (Legal Business Name): CENTRAL TEXAS DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 COLLECTIVE WAY SUITE 110
LEANDER TX
78641
US

IV. Provider business mailing address

4101 IDLEWILD RD
AUSTIN TX
78731-6148
US

V. Phone/Fax

Practice location:
  • Phone: 512-737-4107
  • Fax: 512-631-0182
Mailing address:
  • Phone: 512-737-4107
  • Fax: 512-631-0182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIK MECKEL
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 214-966-2265