Provider Demographics
NPI:1629847827
Name:JAMES, WAYMOND
Entity Type:Individual
Prefix:
First Name:WAYMOND
Middle Name:
Last Name:JAMES
Suffix:
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 1:7575 CALLAGHAN RD APT 1305
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2879
Mailing Address - Country:US
Mailing Address - Phone:210-324-7963
Mailing Address - Fax:
Practice Address - Street 1:7575 CALLAGHAN RD APT 1305
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2879
Practice Address - Country:US
Practice Address - Phone:210-324-7963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171WH0202X
TX171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications