Provider Demographics
NPI:1053329623
Name:HEPTIG, JAMES JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:HEPTIG
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 1:5904 CHAPEL HILL BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5925
Mailing Address - Country:US
Mailing Address - Phone:972-608-4411
Mailing Address - Fax:972-608-4412
Practice Address - Street 1:5904 CHAPEL HILL BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5925
Practice Address - Country:US
Practice Address - Phone:972-608-4411
Practice Address - Fax:972-608-4412
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606245OtherBCBS
TXU84758Medicare UPIN
TX609519Medicare ID - Type Unspecified