Provider Demographics
NPI:1033342639
Name:RILEY, JAMES S (CPO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:RILEY
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 NE LOOP 286 STE A
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-3452
Mailing Address - Country:US
Mailing Address - Phone:903-785-8922
Mailing Address - Fax:
Practice Address - Street 1:2619 NE LOOP 286 STE A
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-3452
Practice Address - Country:US
Practice Address - Phone:903-785-8922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-29
Last Update Date:2009-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist