Organization
CENTAL TEXAS PAIN INSTITUTE, PA
Active
Other names
PAIN SPECIALISTS OF AUSTIN
Organization subpart
No
Provider details
NPI number
Authorized official
ELENA FUENTES (AO)
(512) 485-7200
Entity
Organization
Contact information
Practice address
3401 E MAIN ST, GATESVILLE, TX 76528-2694
(512) 485-7200
(512) 485-7220
Mailing address
PO BOX 208361, DALLAS, TX 75320-8361
(512) 485-7208
(844) 364-8678
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
J7566
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00R03W
MEDICARE PTAN
TX
Enumeration date
11/17/2015
Last updated
09/30/2021
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