Provider Demographics
NPI:1629682919
Name:CENTRAL TEXAS ORTHOPAEDIC FOOT AND ANKLE CENTER, PLLC
Entity Type:Organization
Organization Name:CENTRAL TEXAS ORTHOPAEDIC FOOT AND ANKLE CENTER, PLLC
Other - Org Name:CENTRAL TX ORTHOPAEDIC FOOT & ANKLE CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BEDNARZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-202-8115
Mailing Address - Street 1:5100 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-6922
Mailing Address - Country:US
Mailing Address - Phone:336-202-8115
Mailing Address - Fax:254-522-7964
Practice Address - Street 1:5100 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-6922
Practice Address - Country:US
Practice Address - Phone:254-313-9559
Practice Address - Fax:254-522-7964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-03
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Single Specialty