Basic Information
| Provider Information | |||||||||
| NPI: | 1609400290 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORTHOPAEDIC ASSOCIATES OF CENTRAL TEXAS SURGERY CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7600 N CAPITAL OF TEXAS HWY STE A | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787311181 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122440766 | ||||||||
| FaxNumber: | 5122441013 | ||||||||
| Practice Location | |||||||||
| Address1: | 7600 N CAPITAL OF TEXAS HWY STE A | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787311181 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122440766 | ||||||||
| FaxNumber: | 5122441013 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2020 | ||||||||
| LastUpdateDate: | 05/09/2022 | ||||||||
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| AuthorizedOfficialLastName: | JOBE | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
| AuthorizedOfficialMiddleName: | TAYLOR | ||||||||
| AuthorizedOfficialTitleorPosition: | BOARD PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5122440766 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.