Provider Demographics
NPI:1144215260
Name:COLGIN, JAMES (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:COLGIN
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 1:2108 HUNTER RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5155
Mailing Address - Country:US
Mailing Address - Phone:512-396-2662
Mailing Address - Fax:512-395-8700
Practice Address - Street 1:2108 HUNTER RD
Practice Address - Street 2:STE 114
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5155
Practice Address - Country:US
Practice Address - Phone:512-396-2662
Practice Address - Fax:512-395-8700
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC4328111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDC4328OtherLICENSE
TX601674Medicare ID - Type Unspecified
TXUT12735Medicare UPIN