Individual provider Active NPI

Christian Trevor Boggess, OD

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1639912892
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11187 Issued in TX
Practice address
1742 N Loop 1604 E Ste 117
San Antonio, TX 78232-1594
Phone
(210) 403-9050
NPI assigned
Jun 17, 2024
Last updated
Nov 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11187 TX Primary

Addresses

Primary practice location

1742 N Loop 1604 E Ste 117
San Antonio, TX 78232-1594

Mailing address

1742 N Loop 1604 E Ste 117
San Antonio, TX 78232-1594
Phone (210) 403-9050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240726001000 TX Practitioner - Optometry 6002352010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Androzo Enterprises, PLLCGroup PAC ID 6204050586, 3 clinicians

Practice addresses (Care Compare)

1742 N Loop 1604
Suite 117
San Antonio, TX 78232-1594
Phone (210) 403-9050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11187TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Androzo Enterprises, PLLC CurrentSince Oct 29, 2025 Accepting new patients

Locations

1742 N Loop 1604 E
Ste 117
San Antonio, TX 78232
Phone (210) 403-9050

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1639912892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1742 N LOOP 1604 E STE 117",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321594",
            "telephone_number": "210-403-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 N LOOP 1604 E STE 117",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321594",
            "telephone_number": "210-403-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGESS",
        "first_name": "CHRISTIAN",
        "middle_name": "TREVOR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-17",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.