Pro-Care Spine Center, PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PRO-CARE SPINE CENTER, PLLC

Doing business as

Pro-Care Medical Center

Practice address

9727 Poteet Jourdanton Fwy
Suite 101
San Antonio, TX 78211-4574

Phone

(210) 881-0630

Fax

(210) 641-1608

NPI assigned

Feb 13, 2017

Organization subpart

No

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

Authorized official

Name

Garland Brent Boecking

Title

Ceo

Phone

(512) 371-7478

Specialties & licenses 2

Addresses

Other names 1

• Pro-Care Medical Center Doing business as

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1407395353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 W 39TH 1/2 ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787564005",
            "telephone_number": "512-371-7478",
            "fax_number": "512-371-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9727 POTEET JOURDANTON FWY",
            "address_2": "SUITE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782114574",
            "telephone_number": "210-881-0630",
            "fax_number": "210-641-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-CARE SPINE CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "BOECKING",
        "authorized_official_first_name": "GARLAND",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-371-7478"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pro-Care Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pro First Assisting
• Pro Re Nata Home Healthcare, LLC (Pro Re Nata Home Healthcare)
• Pro Sports Rehab LLC (Pro Sports Rehab Physical Therapy)
• Pro-Active Neurology & Sports Rehab
• Pro-Care Spine Center, LLC (Pro-Care Medical Center)
• Pro-Care Spine Center, PLLC (Pro-Care Medical Center)
• Proactive ABA Services LLC
• Proactive MD TX Professional Corporation (Proactive MD Tindall San Antonio)
• Procare Direct Access PLLC
• Procare Internal Medicine Associates, PLLC

• General Practice Physician in San Antonio, TX
• Providers in San Antonio, 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 Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.