MEDICARE: CENTRAL TEXAS PAIN CENTER, PLLC

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	208VP0014X	Interventional Pain Medicine Physician	L9364	TX
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	208VP0014X	Interventional Pain Medicine Physician

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	:	1891792776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL TEXAS PAIN CENTER, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 208354
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-8354
Country	:	US
Telephone Number	:	512-485-7208
Fax Number	:	844-364-8678

Provider Business Practice Location Address
First Line	:	213 HUNTERS VLG
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78132-4764
Country	:	US
Telephone Number	:	855-876-7246
Fax Number	:	855-277-5070

Authorized Official
Title or Position	:	MD/OWNER
Name	:	DR. DANIEL FREDERICK
Credential	:	MD
Telephone Number	:	512-485-7208

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/22/2025

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