Provider Demographics
NPI:1821779117
Name:JAMES, MARILYN (DPT)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3811 CHAMPIONS DR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-7767
Mailing Address - Country:US
Mailing Address - Phone:936-635-9872
Mailing Address - Fax:
Practice Address - Street 1:12400 GREGG MANOR RD STE 101
Practice Address - Street 2:
Practice Address - City:MANOR
Practice Address - State:TX
Practice Address - Zip Code:78653-4169
Practice Address - Country:US
Practice Address - Phone:737-256-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist