Provider Demographics
NPI:1649395773
Name:EDWARDS, JAMES RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RAY
Last Name:EDWARDS
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 1:4530 MONTANA AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-4700
Mailing Address - Country:US
Mailing Address - Phone:915-562-5700
Mailing Address - Fax:915-562-5703
Practice Address - Street 1:4530 MONTANA AVE
Practice Address - Street 2:SUITE D
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-4700
Practice Address - Country:US
Practice Address - Phone:915-562-5700
Practice Address - Fax:915-562-5703
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10558111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor