Provider Demographics
NPI:1497721435
Name:EDWARDS, JAMES D (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6800 W GATE BLVD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-4883
Mailing Address - Country:US
Mailing Address - Phone:512-445-3366
Mailing Address - Fax:512-444-8283
Practice Address - Street 1:6800 W GATE BLVD
Practice Address - Street 2:SUITE 117
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-4883
Practice Address - Country:US
Practice Address - Phone:512-445-3366
Practice Address - Fax:512-444-8283
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9104111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT86056Medicare UPIN
TX8890B7Medicare ID - Type Unspecified