Provider Demographics
NPI:1215114731
Name:CENTRAL TEXAS PAIN INSTITUTE, PLLC
Entity type:Organization
Organization Name:CENTRAL TEXAS PAIN INSTITUTE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF RCM
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:OPALAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-485-7200
Mailing Address - Street 1:PO BOX 208361
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-8361
Mailing Address - Country:US
Mailing Address - Phone:124-857-2085
Mailing Address - Fax:844-364-8678
Practice Address - Street 1:3101 HIGHWAY 71 E STE 211
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-5156
Practice Address - Country:US
Practice Address - Phone:855-876-7246
Practice Address - Fax:855-277-5070
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSA PRACTICE HOLDINGS PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-28
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0R03WMedicare UPIN