Healthcare Provider Details

I. General information

NPI: 1922384056
Provider Name (Legal Business Name): JOSE NEGRON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2011
Last Update Date: 07/30/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PR-109 K.M. 2 ANASCO ARRIBA
ANASCO PR
00610-0061
US

IV. Provider business mailing address

PO BOX 1861
ANASCO PR
00610-1861
US

V. Phone/Fax

Practice location:
  • Phone: 469-432-3837
  • Fax:
Mailing address:
  • Phone: 469-432-3837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number11839
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number501
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number501
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: