Pro-Active Neurology & Sports Rehab

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

J9179 Issued in TX

Legal business name

PRO-ACTIVE NEUROLOGY & SPORTS REHAB

Practice address

7355 Barlite Blvd Ste 101
San Antonio, TX 78224-1340

Phone

(210) 333-1477

Fax

(210) 558-0520

NPI assigned

Oct 26, 2015

Organization subpart

No

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

Authorized official

Name

Robert C Lowry, M.D.

Title

Owner

Phone

(210) 333-1477

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445817600000",
    "number": "1831561208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7355 BARLITE BLVD STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782241340",
            "telephone_number": "210-333-1477",
            "fax_number": "210-558-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7355 BARLITE BLVD STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782241340",
            "telephone_number": "210-333-1477",
            "fax_number": "210-558-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-ACTIVE NEUROLOGY & SPORTS REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A",
        "authorized_official_last_name": "LOWRY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-333-1477",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TX",
            "license": "J9179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131296907",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PRN Medstaff Homecare Inc
• PRN Medstaff LLC
• Pro First Assisting
• Pro Re Nata Home Healthcare, LLC
• Pro Sports Rehab LLC
• Pro-Care Spine Center, LLC
• Pro-Care Spine Center, PLLC
• Pro-Care Spine Center, PLLC
• Proactive MD TX Professional Corporation
• Procare Direct Access PLLC

• Preferred Provider Organization in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; 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.