A.G. Braddick, D.C., P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2170 Issued in TX

Legal business name

A.G. BRADDICK, D.C., P.C.

Doing business as

New Life Chiropractic Center

Practice address

1305 1St St E
Humble, TX 77338-4925

Phone

(281) 446-1041

Fax

(281) 446-4885

NPI assigned

Jun 18, 2008

Last updated

Oct 1, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Anthony George Braddick, D.C.NPI 1740365899

Title

President

Phone

(281) 446-1041

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• New Life Chiropractic Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony George Braddick, D.C., P.C.

  • Chiropractor
  • Humble, TX
  • NPI 1740365899
  Authorized official Same address or phone

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1760643233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 1ST ST E STE A",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384855",
            "telephone_number": "281-446-1041",
            "fax_number": "281-446-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 1ST ST E",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384925",
            "telephone_number": "281-446-1041",
            "fax_number": "281-446-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A.G. BRADDICK, D.C., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "BRADDICK",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-446-1041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "2170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DO2351",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Life Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.