Provider Demographics
NPI:1689284960
Name:NOTTE, JAMES RAYMOND
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RAYMOND
Last Name:NOTTE
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 1:1500 E RIVERSIDE DR APT 326
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-1151
Mailing Address - Country:US
Mailing Address - Phone:440-228-1988
Mailing Address - Fax:
Practice Address - Street 1:1395 SATTLER RD STE 8
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:TX
Practice Address - Zip Code:78132-2296
Practice Address - Country:US
Practice Address - Phone:830-964-3615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49962183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist