Provider Demographics
NPI:1376817486
Name:JAMES H. ELDER, III D.O., P.A.
Entity Type:Organization
Organization Name:JAMES H. ELDER, III D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:ELDER
Authorized Official - Suffix:III
Authorized Official - Credentials:DO
Authorized Official - Phone:817-637-8515
Mailing Address - Street 1:5900 OVERTON RIDGE BLVD, SUITE 110
Mailing Address - Street 2:C/O TRINITYXPRESSMED
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-2258
Mailing Address - Country:US
Mailing Address - Phone:817-423-1477
Mailing Address - Fax:817-423-1481
Practice Address - Street 1:5900 OVERTON RIDGE BLVD, SUITE 110
Practice Address - Street 2:C/O TRINITYXPRESSMED
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-2258
Practice Address - Country:US
Practice Address - Phone:817-423-1477
Practice Address - Fax:817-423-1481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3630111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Multi-Specialty