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General NPI Number Information
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NPI Number | 1932573714
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Entity Type | Organization
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Legal Business Name | CENTRAL TEXAS PAIN CENTER, PLLC
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 305 CLINITE GROVE BLVD
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City | TEMPLE
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State | TX
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Zip | 76502-2367
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Country | US
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Telephone | 855-876-7246
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Fax | 855-277-5070
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Provider Business Mailing Address
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Address Line | PO BOX 208364
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City | DALLAS
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State | TX
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Zip | 75320-8364
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Country | US
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Telephone | 512-485-7208
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Fax | 844-364-8678
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Authorized Official
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Title or Position | MD/AUTHORIZED OFFICER
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Name | DANIEL FREDERICK
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Credential |
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Telephone | 512-485-7208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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