Individual provider Active NPI

John Anthony Mireles III, D.C.

  • Chiropractor
  • Jbsa Lackland AFB, TX
National Provider Identifier
1952425530
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8370 Issued in TX
Practice address
1100 Wilford Hall Loop, BLDG 4554
Jbsa Lackland AFB, TX 78236-9908
Phone
(210) 292-3715
NPI assigned
Mar 19, 2007
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8370 TX Primary

Addresses

Primary practice location

1100 Wilford Hall Loop, BLDG 4554
Jbsa Lackland AFB, TX 78236-9908

Mailing address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland AFB, TX 78236-9908
Phone (210) 292-3715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130806000343 TX Practitioner - Chiropractic 0042452963 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
GMG Health Systems Associates PA CurrentSince Jan 16, 2023 Accepting new patients
Mission Chiropractic and Injury Clinic, P.a. Chiropractor Past Accepting new patients
Radiology Associates of Southwest Louisiana PastSince Jun 12, 2022 Accepting new patients

Locations

720 Pleasanton Rd
San Antonio, TX 78214

7219 Culebra Rd
San Antonio, TX 78251
Phone (210) 509-2603

902 Bandera Rd
San Antonio, TX 78228
Phone (210) 431-4503

Organizations & group practices 3

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1952425530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND AFB",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP, BLDG 4554",
            "city": "JBSA LACKLAND AFB",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRELES",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland AFB, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.