Provider Demographics
NPI:1356680177
Name:XAVIER, JAMES M (OTR)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:XAVIER
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3184 W MONTCLAIR ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5598
Mailing Address - Country:US
Mailing Address - Phone:417-693-1376
Mailing Address - Fax:
Practice Address - Street 1:3184 W MONTCLAIR ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5598
Practice Address - Country:US
Practice Address - Phone:417-693-1376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO003212225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist