Provider Demographics
NPI:1487888905
Name:CENTRAL TEXAS PAIN SOLUTIONS
Entity type:Organization
Organization Name:CENTRAL TEXAS PAIN SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-364-2945
Mailing Address - Street 1:15112 SUNNINGDALE ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-3818
Mailing Address - Country:US
Mailing Address - Phone:512-364-2945
Mailing Address - Fax:512-248-8611
Practice Address - Street 1:15112 SUNNINGDALE ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-3818
Practice Address - Country:US
Practice Address - Phone:512-364-2945
Practice Address - Fax:512-248-8611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies