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NPI Code Detail

MEDICARE: DR. NICHOLAS ROGER BOSSE D.C.

MEDICARE:  DR. NICHOLAS ROGER BOSSE  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor13606TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1013497OTHERNYCHIROPRACTIC LICENSE
213606OTHERTXCHIROPRACTIC LICENSE
34678OTHERSCCHIROPRACTIC LICENSE

General Provider Information

NPI Number : 1629368709
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS ROGER BOSSE D.C.
Provider Business Mailing Address
First Line : PO BOX 700688
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78270-0688
Country : US
Telephone Number : 800-404-6050
Fax Number : 866-313-3397
Provider Business Practice Location Address
First Line : 375 FM 548 STE 190
Second Line :
City : FORNEY
State : TX
Zip : 75126-6970
Country : US
Telephone Number : 800-404-6050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2011
Last Update Date : 02/20/2026

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Directions to “ DR. NICHOLAS ROGER BOSSE D.C.” Practice Location

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