Provider Demographics
NPI:1487719910
Name:LEWIS, JAMES DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:LEWIS
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 1:1412 LINDA DR
Mailing Address - Street 2:
Mailing Address - City:DAINGERFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:75638-2132
Mailing Address - Country:US
Mailing Address - Phone:903-645-2225
Mailing Address - Fax:903-645-2631
Practice Address - Street 1:1412 LINDA DR
Practice Address - Street 2:
Practice Address - City:DAINGERFIELD
Practice Address - State:TX
Practice Address - Zip Code:75638-2132
Practice Address - Country:US
Practice Address - Phone:903-645-2225
Practice Address - Fax:903-645-2631
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2934111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT14408Medicare UPIN
TX601186Medicare ID - Type UnspecifiedCHIROPRACTOR