MEDICARE: DR. JAMES STRATTON POULSON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	14883	TX

General Provider Information

NPI Number	:	1548930449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES STRATTON POULSON DC

Provider Business Mailing Address
First Line	:	9233 CHURCH RD APT 111
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4973
Country	:	US
Telephone Number	:	469-733-5138
Fax Number	:

Provider Business Practice Location Address
First Line	:	136 GLASS ST STE 140
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75207-6930
Country	:	US
Telephone Number	:	424-777-2739
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2021
Last Update Date	:	09/14/2021

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