Provider Demographics
NPI:1346400595
Name:WHITAKER, JAMES K III
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:K
Last Name:WHITAKER
Suffix:III
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 1:179 RAWHIDE TRL
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75021-4225
Mailing Address - Country:US
Mailing Address - Phone:903-624-1335
Mailing Address - Fax:
Practice Address - Street 1:1114 MLK ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-2136
Practice Address - Country:US
Practice Address - Phone:903-624-1335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral