Active NPI
Dominic Bracero, MD
- Internal Medicine Physician
- Jbsa Lackland, TX
National Provider Identifier
1982235388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- U9215
- Practice address
- 1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638 - Phone
- (210) 292-7805
- NPI assigned
- Feb 4, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101274713 | VA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | U9215 | TX | Primary |
Addresses
Primary practice location
1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Mailing address
1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Phone (210) 298-2483
Other practice location 1
3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-4141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101274713 | VA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1982235388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365638",
"telephone_number": "210-298-2483",
"fax_number": "210-292-7964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365638",
"telephone_number": "210-292-7805"
}
],
"practiceLocations": [
{
"address_1": "3551 Roger Brooke Dr",
"address_purpose": "LOCATION",
"city": "Jbsa Ft Sam Houston",
"state": "TX",
"postal_code": "782344504",
"country_code": "US",
"telephone_number": "210-916-4141",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRACERO",
"first_name": "DOMINIC",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-04",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101274713",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "U9215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jbsa Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.