Provider Demographics
NPI:1265021323
Name:JAMES, TABARUS (LMT)
Entity type:Individual
Prefix:
First Name:TABARUS
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13423 MAGNOLIA BRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-6522
Mailing Address - Country:US
Mailing Address - Phone:210-689-8357
Mailing Address - Fax:
Practice Address - Street 1:7122 SAN PEDRO AVE STE 106
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6233
Practice Address - Country:US
Practice Address - Phone:210-967-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT0129278225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist