Juan C Vidales, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

15543 Issued in TX

Practice address

850 S Greenville Ave Ste 104
Richardson, TX 75081-5046

Phone

(972) 644-6336

Fax

(972) 644-7247

NPI assigned

Feb 25, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Traxler Chiropractic PAGroup PAC ID 7113820077, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Traxler Chiropractic PA

  • Chiropractor
  • Rowlett, TX
  • NPI 1629193669
  Medicare reassignment Care Compare group NPD
• Turner Chiropractic

  • Chiropractor
  • Rockwall, TX
  • NPI 1245402809
  Medicare reassignment NPD
• Plata Investments PA

  • Chiropractor
  • Dallas, TX
  • NPI 1669694105
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1023602406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S GREENVILLE AVE STE 104",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750815046",
            "telephone_number": "972-644-6336",
            "fax_number": "972-644-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S GREENVILLE AVE STE 104",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750815046",
            "telephone_number": "972-644-6336",
            "fax_number": "972-644-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDALES",
        "first_name": "JUAN",
        "middle_name": "C",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-25",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "9039",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "15543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Venturi Holdings, PLLC
• Suzanne Vercontaire, OT
• Mark D Verkler, MSSW, LMFT
• Viabella Express LLC
• Vibra Specialty Hospital of Dallas, LLC
• Hermel Bejosano Videna, LPT
• Zapopa Vielma
• Fatima Viera
• Suma Vijay
• Village Pharmacy Solutions LLC

• Chiropractor in Richardson, TX
• Providers in Richardson, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.