Provider Demographics
NPI:1770879009
Name:COPELAND, JAMES LEROY (BSED)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LEROY
Last Name:COPELAND
Suffix:
Gender:M
Credentials:BSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5625 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:RIVER OAKS
Mailing Address - State:TX
Mailing Address - Zip Code:76114-3328
Mailing Address - Country:US
Mailing Address - Phone:817-991-6429
Mailing Address - Fax:
Practice Address - Street 1:5625 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:RIVER OAKS
Practice Address - State:TX
Practice Address - Zip Code:76114-3328
Practice Address - Country:US
Practice Address - Phone:817-991-6429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist