Provider Demographics
NPI:1689060261
Name:WALKER, JAMES JUSTIN (ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:JUSTIN
Last Name:WALKER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1236
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76099-1236
Mailing Address - Country:US
Mailing Address - Phone:214-498-8114
Mailing Address - Fax:
Practice Address - Street 1:900 O'CONNOR ROAD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061
Practice Address - Country:US
Practice Address - Phone:214-498-8114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-10
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT04922255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer