CENTRAL TEXAS PAIN CENTER NORTH, PLLC (NPI# 1235514704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235514704 |
| Entity Type | Organization |
| Organization Name | CENTRAL TEXAS PAIN CENTER NORTH, PLLC |
| Practice Address |
4316 James Casey St Bldg B, Suite 200 Austin TX 78745-1116 |
| Mailing Address |
Po Box 208354 Dallas TX 75320-8354 |
| Practice Telephone | 5124981029 |
| Practice Fax Number | 5123693366 |
| Mailing Telephone | 5124857208 |
| Mailing Fax Number | 8443648678 |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2020-09-11 |
| Authorized Official Name | DR. DANIEL FREDERICK (MD/OWNER) |
| Authorized Official Telephone | 5124857208 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
L9364 | TX | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
4316 JAMES CASEY ST BLDG B, SUITE 200 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78745-1116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194721829 | Jeffrey W Fluitt | Chiropractor | 4316 James Casey St, Bldg B, Suite 201, Austin, TX 78745-1116 | 2005-06-27 |
| 1528625407 | Kyle Gardner | Chiropractor | 4316 James Casey St, Austin, TX 78745-1116 | 2019-05-25 |
| 1558823591 | Madison Casper | Physician Assistant | 4316 James Casey St, Austin, TX 78745-1116 | 2019-04-01 |
| 1164909529 | Dipti Ashmita Schraegle | Clinical Nurse Specialist | 4316 James Casey St, Austin, TX 78745-1116 | 2018-07-27 |
| 1003329236 | Jessica Anne Brown | Nurse Practitioner | 4316 James Casey St, Austin, TX 78745-1116 | 2017-11-09 |
| 1093174278 | Jordan E Waldron | Physician Assistant | 4316 James Casey St, Bldg B Ste 201, Austin, TX 78745-7874 | 2016-02-17 |
| 1184097982 | Imaging Partners of Austin LLC | Clinic/Center | 4316 James Casey St, F-110b, Austin, TX 78745-1116 | 2015-11-03 |
| 1205203346 | Imaging Partners of Austin LLC | Clinic/Center | 4316 James Casey St, Suite F110-b, Austin, TX 78745-1116 | 2015-08-24 |
| 1346624202 | Liberty Labs LLC | Clinical Medical Laboratory | 4316 James Casey St, Building F, Austin, TX 78745-1116 | 2015-07-10 |
| 1376935031 | Btdi Jv, LLP | Physiological Laboratory | 4316 James Casey St, Suite E-1, Austin, TX 78745-1116 | 2015-03-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617511 | Samantha Lynne Weston | Speech-Language Pathologist | 8515 Brodie Lane, Apt 2011, Austin, TX 78745 | 2020-10-26 |
| 1275172686 | Nithphaphone Tracy Bounsing | Registered Nurse | 4316 James Casey St, Building F, Suite 201, Austin, TX 78745 | 2020-01-02 |
| 1225685712 | Integrative Medical Group of Texas | General Practice | 6905 West Gate Blvd. Ste A, Austin, TX 78745 | 2019-08-20 |
| 1962971499 | Kimberly Angela Mancini | Social Worker | 5015 South Ih 35 Frontage Road, Austin, TX 78745 | 2018-11-14 |
| 1093223885 | Emma Rose Marek | Speech-Language Pathologist | 2700 Norfolk Drive, Austin, TX 78745 | 2018-01-16 |
| 1528586690 | Ashley Ellison | Social Worker | 4201 South Congress, Austin, TX 78745 | 2017-09-08 |
| 1134666761 | Carey Sebera | Counselor | 2812 Goldbridge Dr, Austin, TX 78745 | 2017-01-20 |
| 1932644507 | Maya Conlon | Social Worker | 2501 W. William Cannon Dr., Bldg 6 Ste. A, Austin, TX 78745 | 2017-01-05 |
| 1285189134 | 512 Physical Therapy and Golf Performance Center | Physical Therapist | 6800 Westgate Blvd, Suite 117, Austin, TX 78745 | 2016-08-22 |
| 1326401803 | Chris Winkley | Physical Therapist | 5510 S Ih 35 Frontage Rd #240, Austin, TX 78745 | 2016-04-01 |
| Find all providers in zip 78745 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013472265 | Premiere Pain Specialists LLC | Pain Medicine | 12309 N Mopac Expy Ste 125, Austin, TX 78758-2577 | 2019-02-01 |
| 1871970871 | Gregory Nicholas Yanez | Pain Medicine | 4316 James Casey St Building B Suite 200, Austin, TX 78745 | 2015-04-29 |
| 1578567459 | Integrative Pain Services Pa | Pain Medicine | 4807 Spicewood Springs Rd, Ste 1235, Austin, TX 78759-8478 | 2005-06-09 |
| 1487196614 | Alan D Silberberg, Md Pa | Pain Medicine | 5625 Eiger Rd, Suite 160, Austin, TX 78735-8977 | 2016-11-04 |
| 1821484031 | Jamal Hasoon | Pain Medicine | 4316 James Casey St Ste 200, Austin, TX 78745-1116 | 2015-04-14 |
| 1295130912 | Central Texas Pain Center, Pllc | Pain Medicine | 4316 James Casey St, Bldg B, Suite 200, Austin, TX 78745-1116 | 2014-10-23 |
| 1184987174 | Rahul Sarna | Pain Medicine | 4100 Duval Rd, Bldg IIi Ste 200, Austin, TX 78759 | 2012-06-25 |
| 1336416510 | Robert P Wills Md Pllc | Pain Medicine | 2200 Park Bend Dr, Bldg 1, Suite 201, Austin, TX 78758-5387 | 2011-11-16 |
| 1306124912 | Derrick Wansom | Pain Medicine | 4100 Duval Rd, Bldg 3 Ste 200, Austin, TX 78759-4275 | 2011-07-31 |
| 1053526343 | Pain Management Consultants, Pa | Pain Medicine | 101 W Koenig Ln, Ste 100, Austin, TX 78751-1213 | 2007-05-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.