Healthcare Provider Details

I. General information

NPI: 1023513447
Provider Name (Legal Business Name): MEAGAN VACEK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 BATES AVE STE C1570
HOUSTON TX
77030-2698
US

IV. Provider business mailing address

1102 BATES AVE STE C1570
HOUSTON TX
77030-2617
US

V. Phone/Fax

Practice location:
  • Phone: 832-824-4294
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2021018439
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberV6716
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV6716
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: