Active NPI
Weston Alan Manuel
- General Practice Dentistry
- Boerne, TX
National Provider Identifier
1184325755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 40473
- Practice address
- 430 W Bandera Rd Ste 4B
Boerne, TX 78006-2521 - Phone
- (830) 428-3698
- NPI assigned
- Mar 13, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 40473 | TX | Primary |
Addresses
Primary practice location
430 W Bandera Rd Ste 4B
Boerne, TX 78006-2521
Mailing address
5800 N I 35 Ste 205
Denton, TX 76207-1438
Phone (940) 220-7833
Other practice location 1
8210 Floyd Curl Dr
San Antonio, TX 78229-3923
Phone (210) 450-3700
Other practice location 2
810 S General McMullen Dr Ste 108
San Antonio, TX 78237-3163
Phone (210) 200-8069
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 20, 2026 through May 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40473 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1184325755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5800 N I 35 STE 205",
"city": "DENTON",
"state": "TX",
"postal_code": "762071438",
"telephone_number": "940-220-7833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 W BANDERA RD STE 4B",
"city": "BOERNE",
"state": "TX",
"postal_code": "780062521",
"telephone_number": "830-428-3698"
}
],
"practiceLocations": [
{
"address_1": "8210 Floyd Curl Dr",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782293923",
"country_code": "US",
"telephone_number": "210-450-3700",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "810 S General McMullen Dr Ste 108",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782373163",
"country_code": "US",
"telephone_number": "210-200-8069",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANUEL",
"first_name": "WESTON",
"middle_name": "ALAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-13",
"last_updated": "2024-06-18",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "40473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boerne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.