Provider Demographics
NPI:1235533647
Name:ALLGOOD, JAMES RUSSELL
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RUSSELL
Last Name:ALLGOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5145 FM 620 N STE F-130
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-1815
Mailing Address - Country:US
Mailing Address - Phone:512-554-9937
Mailing Address - Fax:
Practice Address - Street 1:5145 FM 620 N STE F-130
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1815
Practice Address - Country:US
Practice Address - Phone:512-554-9937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12716111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor