Provider Demographics
NPI:1245440510
Name:VAVREK, THOMAS WILLIAM (DO, MS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WILLIAM
Last Name:VAVREK
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Gender:M
Credentials:DO, MS
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Mailing Address - Street 1:1390 S POTOMAC ST
Mailing Address - Street 2:SUITE 128
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-6165
Mailing Address - Country:US
Mailing Address - Phone:303-341-7894
Mailing Address - Fax:720-859-7780
Practice Address - Street 1:1390 S POTOMAC ST
Practice Address - Street 2:SUITE 100
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-6165
Practice Address - Country:US
Practice Address - Phone:303-341-7894
Practice Address - Fax:720-859-7780
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2014-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO46362208100000X, 204D00000X
MI510105436204D00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM