Provider Demographics
NPI:1124250410
Name:CENTRAL TEXAS MEDICAL SPECIALISTS PLLC
Entity type:Organization
Organization Name:CENTRAL TEXAS MEDICAL SPECIALISTS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-334-2654
Mailing Address - Street 1:9715 BURNET RD
Mailing Address - Street 2:BLD 7 STE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5215
Mailing Address - Country:US
Mailing Address - Phone:512-334-2866
Mailing Address - Fax:512-334-2702
Practice Address - Street 1:9715 BURNET RD
Practice Address - Street 2:BLD 7 STE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5215
Practice Address - Country:US
Practice Address - Phone:512-334-2866
Practice Address - Fax:512-334-2702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX270800Medicare PIN