Organization Active NPI

Laguna Madre Chiropractic, P.a.

  • Chiropractor
  • Port Isabel, TX
National Provider Identifier
1245424050
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8502 Issued in TX
Legal business name
LAGUNA MADRE CHIROPRACTIC, P.A.
Practice address
402 S Garcia St
Port Isabel, TX 78578-4103
Phone
(956) 943-9943
NPI assigned
Sep 5, 2007
Last updated
Sep 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Authorized official

Name
Dr. Anthony J Flaig, D.C.NPI 1578689428
Title
President
Phone
(956) 943-9943

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 8502 TX Primary

Addresses

Primary practice location

402 S Garcia St
Port Isabel, TX 78578-4103

Mailing address

402 S Garcia St
Port Isabel, TX 78578-4103
Phone (956) 943-9943

Other identifiers 1

IdentifierTypeStateIssuer
0091JKOtherTXBC / BS GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120119000139 TX Part B Supplier - Clinic/Group Practice 5496922270 Receives reassigned benefits from 1 practitioner
Practice locations: Port Isabel, TX

National Provider Directory

National Provider Directory

Locations

402 S Garcia St
Port Isabel, TX 78578
Phone (956) 943-9943

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1245424050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 S GARCIA ST",
            "city": "PORT ISABEL",
            "state": "TX",
            "postal_code": "785784103",
            "telephone_number": "956-943-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S GARCIA ST",
            "city": "PORT ISABEL",
            "state": "TX",
            "postal_code": "785784103",
            "telephone_number": "956-943-9943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGUNA MADRE CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "FLAIG",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-943-9943",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC / BS GROUP #",
            "identifier": "0091JK",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Isabel, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.