Basic Information
| Provider Information | |||||||||
| NPI: | 1134761935 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRAL TEXAS ANESTHESIA PARTNERS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 791 | ||||||||
| Address2: | |||||||||
| City: | CARNEGIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151060791 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126554362 | ||||||||
| FaxNumber: | 4126537684 | ||||||||
| Practice Location | |||||||||
| Address1: | 12309 N MOPAC EXPY STE 125 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787582577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122303005 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2019 | ||||||||
| LastUpdateDate: | 08/20/2021 | ||||||||
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| AuthorizedOfficialLastName: | KHAN | ||||||||
| AuthorizedOfficialFirstName: | ADNAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 5122303005 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | N9404 | 01 | TX | STATE LICENSE | OTHER |