Corey Alexander Boltz, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

W8296 Issued in TX

Practice address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Phone

(210) 528-6548

Fax

(848) 213-0591

NPI assigned

Feb 10, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mr. Corey Alexander Thomas Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1093520728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-3856",
            "fax_number": "210-916-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-528-6548",
            "fax_number": "848-213-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTZ",
        "first_name": "COREY",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-10",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "W8296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COREY",
            "last_name": "THOMAS",
            "middle_name": "ALEXANDER",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kumalo Akiim Bogan
• Kenneth John Bogenberger, MD
• David McCabe Boland, DPT
• Jeremy Tyler Bolin, MD
• Neil W Boll, DDS
• Robert L Bonar, PT, DPT
• Luis Antonio Bonet Rodriguez
• Otto Boneta, MD
• Melissa Book, DPT
• Scott G. Book, M.D.

• General Practice Physician in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.