Provider Demographics
NPI:1063682417
Name:JAMES N KONTARATOS DC
Entity Type:Organization
Organization Name:JAMES N KONTARATOS DC
Other - Org Name:ADVANCED CHIROPRACTIC NORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:N
Authorized Official - Last Name:KONTARATOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-424-4243
Mailing Address - Street 1:832 W SPRING CREEK PKWY STE 300A
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4635
Mailing Address - Country:US
Mailing Address - Phone:972-424-4243
Mailing Address - Fax:972-424-6211
Practice Address - Street 1:832 W SPRING CREEK PKWY STE 300A
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4635
Practice Address - Country:US
Practice Address - Phone:972-424-4243
Practice Address - Fax:972-424-6211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-01
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5097111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX603827Medicare PIN