MEDICARE: CENTRAL TEXAS SURGICAL ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	389489	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275654170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL TEXAS SURGICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	7200 WYOMING SPGS STE 500
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4307
Country	:	US
Telephone Number	:	512-244-0111
Fax Number	:	512-244-2479

Provider Business Practice Location Address
First Line	:	7200 WYOMING SPGS STE 500
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4307
Country	:	US
Telephone Number	:	512-244-0111
Fax Number	:	512-244-2479

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	LINDA ISCHY
Credential	:
Telephone Number	:	512-879-0089

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	05/16/2023

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