Provider Demographics
NPI:1629164199
Name:THORBURN, JAMES STANLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STANLEY
Last Name:THORBURN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WISHERT RD
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78382-7649
Mailing Address - Country:US
Mailing Address - Phone:361-729-0817
Mailing Address - Fax:361-729-0817
Practice Address - Street 1:110 WISHERT RD
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382-7649
Practice Address - Country:US
Practice Address - Phone:361-729-0817
Practice Address - Fax:361-729-0817
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC 4533111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601842Medicare ID - Type UnspecifiedBCBS PROVICER #