GREAT LAKES HEALTHCARE, INC. (NPI# 1225482557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225482557 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES HEALTHCARE, INC. |
| Other Organization Name | CHIROSPORT |
| Practice Address |
3033 Marina Bay Dr Suite 200 League City TX 77573-3984 |
| Mailing Address |
2437 Bay Area Blvd 139 Houston TX 77058-1519 |
| Practice Telephone | 7134252524 |
| Enumeration Date | 2016-04-23 |
| Last Update Date | 2017-01-19 |
| Authorized Official Name | DR. EARL F. HENDRIKZ (PRESIDENT) |
| Authorized Official Telephone | 7134252524 |
| Authorized Official Credential | DC, CCSP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 11399 | TX | Chiropractic Providers |
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
11399 | TX | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| ChiroSport | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184282618 | Great Lakes Healthcare, Inc. | Physical Therapist | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022-6505 | 2019-05-30 |
| 1619532132 | Great Lakes Healthcare, Inc. | Hospice Care, Community Based | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022 | 2019-05-09 |
| 1255996740 | Great Lakes Healthcare, Inc. | Home Health | W175n11117 Stonewood Dr Ste 100, Germantown, WI 53022 | 2019-05-09 |
| Street Address |
3033 MARINA BAY DR SUITE 200 |
| City | LEAGUE CITY |
| State | TX |
| Zip Code | 77573-3984 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790755973 | John William Fulkman IIi | Chiropractor | 3033 Marina Bay Dr, Suite 200, League City, TX 77573-3984 | 2006-01-23 |
| 1659623171 | Jade Cox | Chiropractor | 3033 Marina Bay Dr, Ste. 200, League City, TX 77573-3984 | 2012-10-08 |
| 1659644920 | Francis Michael Cyran IIi | Chiropractor | 3033 Marina Bay Dr, Suite 200, League City, TX 77573-3984 | 2012-02-17 |
| 1861711491 | Tri-chiropractic Pllc | Chiropractor | 3033 Marina Bay Dr, Suite 200, League City, TX 77573-3984 | 2010-05-21 |
| 1053543579 | John Meredith Doyle | Chiropractor | 3033 Marina Bay Dr, Suite 200, League City, TX 77573-3984 | 2009-08-17 |
| 1821220435 | Kai Borgstrom | Chiropractor | 3033 Marina Bay Dr, Suite 200, League City, TX 77573-3984 | 2009-08-14 |
| 1841420411 | Todd Evert Riddle | Chiropractor | 3033 Marina Bay Dr, League City, TX 77573-3984 | 2009-07-17 |
| 1356505846 | Elena Grantcharova Geppert, Md Pa | Plastic Surgery | 3033 Marina Bay Dr, Suite 110, League City, TX 77573-3984 | 2008-07-14 |
| 1841466679 | Ssh Medical Center | Clinic/Center | 3033 Marina Bay Dr, Suite 100, League City, TX 77573-3984 | 2008-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114527306 | Colin Joe Lee | Pharmacist | 1088 W Main St League City, Tx 77573 United States, League City, TX 77573 | 2020-10-28 |
| 1033764931 | Brittany Salinas | Physical Medicine & Rehabilitation | 2205 Colonial Court N, League City, TX 77573 | 2019-08-07 |
| 1366007833 | Tmh Physician Associates Pllc | Orthopaedic Surgery | 2220 E. League City Parkway, Suite 200, League City, TX 77573 | 2019-05-09 |
| 1851863724 | Gina Carter | Durable Medical Equipment & Medical Supplies | 210 S. Hwy 3, Unit B, League City, TX 77573 | 2018-12-17 |
| 1497226393 | Daniel Max & Marcandrea LLC | Optometrist | 3170 Gulf Freeway South, League City, TX 77573 | 2018-12-17 |
| 1972071983 | Chelsie N Chonoski | Nurse Practitioner | 2240 Gulf Freeway South, Suite 2.110, League City, TX 77573 | 2018-11-07 |
| 1730660564 | Rebecca Ann Peth | Physical Therapist | 350 N Wesley Dr., Apt 1123, League City, TX 77573 | 2018-08-29 |
| 1912485087 | Sarwat Hussain Zaffer | Dentist | 1620 W Fm 646, Ste D, League City, TX 77573 | 2018-08-01 |
| 1518468651 | Clear Creek Chiropractic Center | Clinic/Center | 624 West Main Ste 102, League City, TX 77573 | 2018-02-23 |
| 1255850848 | Travis William Prothro | Chiropractor | 1620 W. Fm 646, Suite C, League City, TX 77573 | 2017-09-14 |
| Find all providers in zip 77573 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952412819 | Taylor Sport Chiropractic Pllc | Chiropractor | 618 W Main St Ste 102, League City, TX 77573-3772 | 2006-08-31 |
| 1477510048 | Thea M Taylor | Chiropractor | 618 W Main St, #102, League City, TX 77573-3773 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385391 | South Texas Sports Chiropractic | Chiropractor | 6635 S Staples St Apt 1815, Corpus Christi, TX 78413-5417 | 2020-11-01 |
| 1740806819 | Dannug Management, LLC | Chiropractor | 9720 Cypresswood Dr Ste 130, Houston, TX 77070-3557 | 2020-06-24 |
| 1134742125 | Kayla Keck | Chiropractor | 7200 Meadow Hill Dr, Frisco, TX 75033-2031 | 2020-05-25 |
| 1942821368 | Stark Chiropractic & Sports, Pllc | Chiropractor | 5625 Fm 1960 Rd W Ste 400, Houston, TX 77069-4211 | 2020-04-27 |
| 1558994996 | Scott David Kimbell | Chiropractor | 3303 Northland Dr Ste 301, Austin, TX 78731-4956 | 2020-02-13 |
| 1194356394 | Kali Mccormick | Chiropractor | 4570 Fm 720, Aubrey, TX 76227-8256 | 2020-01-28 |
| 1467001958 | Catalyst Hl&p, LLC. | Chiropractor | 5177 Richmond Ave Ste 110, Houston, TX 77056-6764 | 2019-09-06 |
| 1487219101 | Moriam Adigun | Chiropractor | 747 N Shepherd Dr, Houston, TX 77007-1335 | 2019-05-08 |
| 1528534518 | Eric Trager | Chiropractor | 5530 Ih 35 S, New Braunfels, TX 78132-4945 | 2018-10-17 |
| 1780150797 | The Pit Fitness & Rehab | Chiropractor | 324 E Belt Line Rd Ste 800, Desoto, TX 75115-5706 | 2018-10-17 |
| Find all providers with the same taxonomy | ||||
| City | LEAGUE CITY |
| Zip Code | 77573 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.