| Central Texas Neurological Association | |
|
205 Woodhew Dr Ste 110 Waco TX 76712-6689 | |
| (254) 399-9291 | |
| (254) 399-8414 |
| Full Name | Central Texas Neurological Association |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 205 Woodhew Dr Ste 110, Waco, Texas |
| Authorized Official Name and Position | Randy C Gardell (PRESIDENT) |
| Authorized Official Contact | 2543999291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Texas Neurological Association 205 Woodhew Dr Ste 110 Waco TX 76712-6689 Ph: (254) 399-9291 | Central Texas Neurological Association 205 Woodhew Dr Ste 110 Waco TX 76712-6689 Ph: (254) 399-9291 |
| NPI Number | 1265516207 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 06/20/2023 |
| Certification Date | 06/20/2023 |
| Medicare PECOS PAC ID | 4486780632 |
|---|---|
| Medicare Enrollment ID | O20110418000764 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265516207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Randy C Gardell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659483873 PECOS PAC ID: 6305972555 Enrollment ID: I20100327000147 |
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