MEDICARE: CENTRAL TEXAS NEUROLOGY CONSULTANTS, PA

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	261QP2000X	Physical Therapy Clinic/Center	661480000	TX
2	174400000X	Specialist

Other Identifiers

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

General Provider Information

NPI Number	:	1790718146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL TEXAS NEUROLOGY CONSULTANTS, PA

Provider Business Mailing Address
First Line	:	16040 PARK VALLEY DRIVE
Second Line	:	BUILDING B SUITE 100
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-3573
Country	:	US
Telephone Number	:	512-218-1222
Fax Number	:	512-218-1393

Provider Business Practice Location Address
First Line	:	16040 PARK VALLEY DR
Second Line	:	BLDG B, SUITE 100
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-3573
Country	:	US
Telephone Number	:	512-218-1222
Fax Number	:	512-218-1393

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	VERNON W CHRISTIE III
Credential	:
Telephone Number	:	512-218-1222

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	06/02/2025

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