Pro-Care Spine Center, PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

F9289 Issued in TX

Legal business name

PRO-CARE SPINE CENTER, PLLC

Doing business as

Pro-Care Medical Center

Practice address

701 E Whitestone Blvd
Ste 100
Cedar Park, TX 78613-6944

Phone

(512) 371-7478

Fax

(512) 371-3861

NPI assigned

Oct 4, 2016

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

Locations

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1730639618",
    "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": "701 E WHITESTONE BLVD",
            "address_2": "STE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786136944",
            "telephone_number": "512-371-7478",
            "fax_number": "512-371-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-CARE SPINE CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "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": "9693",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "F9289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pro-Care Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Cedar Park, TX
• Providers in Cedar Park, 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 Oct 4, 2016; 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.