Provider Demographics
NPI:1134884257
Name:JACQUES, JAMES OLIVER (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:OLIVER
Last Name:JACQUES
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 1:807 E 4TH ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-3828
Mailing Address - Country:US
Mailing Address - Phone:518-944-3000
Mailing Address - Fax:
Practice Address - Street 1:807 E 4TH ST UNIT 9
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-3828
Practice Address - Country:US
Practice Address - Phone:518-944-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty