Provider Demographics
NPI:1043415193
Name:OSTERWISE, JAMES W (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:OSTERWISE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 COIT RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-3794
Mailing Address - Country:US
Mailing Address - Phone:972-519-1618
Mailing Address - Fax:972-519-0121
Practice Address - Street 1:2321 COIT RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3794
Practice Address - Country:US
Practice Address - Phone:972-519-1618
Practice Address - Fax:972-519-0121
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6097111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605336Medicare ID - Type Unspecified