Provider Demographics
NPI:1588330302
Name:CENTRAL TEXAS ANESTHESIA PARTNERS PLLC
Entity type:Organization
Organization Name:CENTRAL TEXAS ANESTHESIA PARTNERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-400-4195
Mailing Address - Street 1:1900 SCENIC DR # 1108
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7724
Mailing Address - Country:US
Mailing Address - Phone:512-400-4195
Mailing Address - Fax:877-260-0030
Practice Address - Street 1:1900 SCENIC DR STE 1108
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7724
Practice Address - Country:US
Practice Address - Phone:512-400-4195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ2046OtherSTATE LICENSE