Individual provider Active NPI

John M Vaclavik, DC

  • Chiropractor
  • League City, TX
National Provider Identifier
1790798726
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5608 Issued in TX
Practice address
212 Gulf Fwy S
Suite G-1
League City, TX 77573-3524
Phone
(281) 332-6816
Fax
(281) 338-9998
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5608 TX Primary

Addresses

Primary practice location

212 Gulf Fwy S
Suite G-1
League City, TX 77573-3524

Mailing address

212 Gulf Fwy S
Suite G-1
League City, TX 77573-3524
Phone (281) 332-6816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5608TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Associates, P.C. Chiropractor Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790798726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 GULF FWY S",
            "address_2": "SUITE G-1",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733524",
            "telephone_number": "281-332-6816",
            "fax_number": "281-338-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 GULF FWY S",
            "address_2": "SUITE G-1",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733524",
            "telephone_number": "281-332-6816",
            "fax_number": "281-338-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACLAVIK",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "5608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.