Provider Demographics
NPI:1336202126
Name:KONTARATOS, JAMES N (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:N
Last Name:KONTARATOS
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 1:4682 MCDERMOTT RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7772
Mailing Address - Country:US
Mailing Address - Phone:972-424-4243
Mailing Address - Fax:972-424-6211
Practice Address - Street 1:4682 MCDERMOTT RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-7772
Practice Address - Country:US
Practice Address - Phone:972-424-4243
Practice Address - Fax:972-424-6211
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5097111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4390471OtherAETNA
TXDC5097OtherSTATE LICENSE
TX8K8396OtherBLUE CROSS BLUE SHIELD TX
TXDC5097Medicare UPIN
TX8K8396OtherBLUE CROSS BLUE SHIELD TX