Active NPI
Pro-Care Spine Center, PLLC
- General Practice Physician
- San Antonio, TX
National Provider Identifier
1699214536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- PRO-CARE SPINE CENTER, PLLC
- Practice address
- 7403 W Loop 1604 N
Suite 103
San Antonio, TX 78254-1888 - Phone
- (210) 881-0630
- Fax
- (210) 641-1608
- NPI assigned
- Feb 13, 2017
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | TX | ||
| General Practice Physician | 208D00000X | TX | Primary |
Addresses
Primary practice location
7403 W Loop 1604 N
Suite 103
San Antonio, TX 78254-1888
Mailing address
1015 W 39TH 1/2 St
Austin, TX 78756-4005
Phone (512) 371-7478
Other names 1
- Pro-Care Medical Center
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Fort Worth, TX
- NPI 1033225461
NPI Registry JSON
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": "1699214536",
"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": "7403 W LOOP 1604 N",
"address_2": "SUITE 103",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782541888",
"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": "TX",
"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"
}
]
}
Other providers in San Antonio, TX
Sources for this page
- 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.