PRO PHYSICIANS CLINIC PA NPI 1821229717

NPI Information

  • NPI: 1821229717
  • Provider Name: PRO PHYSICIANS CLINIC, PA
  • Classification: Radiology - 2085R0001X
  • Specialization: Radiation Oncology
  • Entity Type: Organization
  • Doing Business As: PRO PHYSICIANS CLINIC, PA
  • Address: 12705 TOEPPERWEIN RD
    LIVE OAK, TX
    ZIP 78233
  • Phone: (210) 816-4770

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NPI Details

PRO PHYSICIANS CLINIC, PA is a radiation oncology radiology in Live Oak, TX. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. PRO PHYSICIANS CLINIC, PA NPI is 1821229717. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pro Physicians Clinic, Pa.

The provider's business location address is:

12705 TOEPPERWEIN RD
LIVE OAK, TX
ZIP 78233-257
Phone: (210) 816-4770
Fax: (210) 816-4771

The provider's authorized official is Jon D Tryggestad .
The authorized official title is Ceo and has the following contact phone number (817) 886-8730.

The enumeration date for this NPI number is 7/27/2009 and was last updated on 2/25/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0001XRadiologyRadiation OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10A3406OTHERTEXASMEDICARE PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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