Provider Demographics
NPI:1245265545
Name:PREDIGER, JAMES P (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:PREDIGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 S LOOP 288
Mailing Address - Street 2:SUITE 334
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4981
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2215 S LOOP 288
Practice Address - Street 2:SUITE 334
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4981
Practice Address - Country:US
Practice Address - Phone:940-484-7258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4737T152W00000X
OK2079152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist