Anello John D'Ambra, D.C.
Individual provider Active NPI Chiropractor · Galveston, TX
NPI 1104990332 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104990332
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 6422 (TX)
- Practice address
- 2006 45TH St
Galveston, TX 77550-7315 - Phone
- (409) 763-5900
- Fax
- (409) 763-5916
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 1994
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2006 45TH St
Galveston, TX 77550-7315
Phone (409) 763-5900
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040513000782 | TX | Practitioner - Chiropractic | 8325038227 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6422 | TX | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Island Chiropractic & Rehabilitation, P.a. | Chiropractor | Current |
Accepting new patients |
Locations
2006 45th St
Galveston, TX 77550
Phone (409) 763-5900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6422 | TX | Yes |
Addresses
Primary practice location
2006 45TH St
Galveston, TX 77550-7315
Mailing address
2006 45TH St
Galveston, TX 77550-7315
Phone (409) 763-5900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8M7070 | Other | TX | BCBSTX PROVIDER NUMBER |
Other providers in Galveston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.