Great Lakes Healthcare, Inc.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

11399 Issued in TX

Legal business name

GREAT LAKES HEALTHCARE, INC.

Doing business as

ChiroSport

Practice address

3033 Marina Bay Dr
Suite 200
League City, TX 77573-3984

Phone

(713) 425-2524

NPI assigned

Apr 23, 2016

Last updated

Jan 19, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Earl F. Hendrikz, DC, CCSPNPI 1144520735

Title

President

Phone

(713) 425-2524

Specialties & licenses 2

Addresses

Other names 1

• ChiroSport Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Earl Franklin Hendrikz, D.C., C.C.S.P.

  • Chiropractor
  • Houston, TX
  • NPI 1144520735
  Authorized official Same address or phone

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

{
    "created_epoch": "1461369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484784000000",
    "number": "1225482557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2437 BAY AREA BLVD",
            "address_2": "139",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770581519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 MARINA BAY DR",
            "address_2": "SUITE 200",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733984",
            "telephone_number": "713-425-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-23",
        "last_updated": "2017-01-19",
        "status": "A",
        "authorized_official_last_name": "HENDRIKZ",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-425-2524",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, CCSP"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11399",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "TX",
            "license": "11399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ChiroSport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dalila Green
• Jordan Green
• Lakeshur Rosha Green, FNP
• Miranda Nicole Green

• Sports Physician Chiropractor in League City, TX
• Providers in League City, TX by specialty
• Sports Physician Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.