Dwayne A Kubecka, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6561 Issued in TX

Practice address

2334 Hwy 361
Suite 162
Ingleside, TX 78362-4127

Phone

(361) 776-0030

Fax

(361) 776-0731

NPI assigned

Aug 7, 2007

Last updated

Apr 15, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mayfield Chiropractic

  • Chiropractor
  • Ingleside, TX
  • NPI 1356438295
  NPD (past) Authorized official
• Texas Spine & Rehab Center

  • Clinic/Center
  • Ingleside, TX
  • NPI 1922279702
  NPD (past) Authorized official

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1386835122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 HWY 361",
            "address_2": "SUITE 162",
            "city": "INGLESIDE",
            "state": "TX",
            "postal_code": "783624127",
            "telephone_number": "361-776-0030",
            "fax_number": "361-776-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2334 HWY 361",
            "address_2": "SUITE 162",
            "city": "INGLESIDE",
            "state": "TX",
            "postal_code": "783624127",
            "telephone_number": "361-776-0030",
            "fax_number": "361-776-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBECKA",
        "first_name": "DWAYNE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "6561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8AJ308",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA #",
            "identifier": "5613511",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ingleside Medical & Aesthetics PLLC
• Inglesie Isd
• Lupita Jasso
• Jerry's Pharmacy, LTD
• Raymond Louis Johnson, IDC
• Patti J Licona, LCSW
• Damian J Lovello, IDC
• Mayfield Chiropractic
• Idana Merrick, R.PH.
• Andrea Lenore Middagh

• Chiropractor in Ingleside, TX
• Providers in Ingleside, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; 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.