Provider Demographics
NPI:1316956832
Name:CENTRAL TEXAS PAIN INSTITUTE PLLC
Entity type:Organization
Organization Name:CENTRAL TEXAS PAIN INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:FEATHERSTON
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:512-953-8135
Mailing Address - Fax:844-364-8678
Practice Address - Street 1:4100 DUVAL RD STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3550
Practice Address - Country:US
Practice Address - Phone:855-876-7246
Practice Address - Fax:855-277-5070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7566174400000X
332B00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K5001OtherDAWN PTAN
TX8K4516OtherSATURDAY PTAN
TX8K5000OtherHEATHER PTAN
TX8K2271OtherPAUL PTAN
TX8K2271OtherPAUL PTAN
TX8K5000OtherHEATHER PTAN