Active NPI
Ray Wolbrecht
- Dentist
- Kyle, TX
National Provider Identifier
1578710349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12394
- Practice address
- 900 Rebel Rd
Kyle, TX 78640 - Phone
- (512) 268-4011
- Fax
- (512) 268-0409
- NPI assigned
- Aug 25, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 12394 | TX | Primary |
Addresses
Primary practice location
900 Rebel Rd
Kyle, TX 78640
Mailing address
PO Box 365
Kyle, TX 78640-0365
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12394 | TX | MD | Community Health Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McIntyre Family Dentistry, PLLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219622400000",
"number": "1578710349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 365",
"city": "KYLE",
"state": "TX",
"postal_code": "786400365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 REBEL RD",
"city": "KYLE",
"state": "TX",
"postal_code": "78640",
"telephone_number": "512-268-4011",
"fax_number": "512-268-0409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLBRECHT",
"first_name": "RAY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-08-25",
"last_updated": "2008-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "12394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kyle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.