Provider Demographics
NPI:1457629529
Name:RAPP, JAMES WHALEY (MS, ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WHALEY
Last Name:RAPP
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5801 RALEIGH DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-5633
Mailing Address - Country:US
Mailing Address - Phone:903-590-2178
Mailing Address - Fax:903-531-5770
Practice Address - Street 1:430 SOUTH BECKHAM AVENUE
Practice Address - Street 2:TRINITY MOTHER FRANCES SPORTS MEDICINE
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702
Practice Address - Country:US
Practice Address - Phone:903-590-2178
Practice Address - Fax:903-531-5770
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT27202255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer