Healthcare Provider Details

I. General information

NPI: 1942484795
Provider Name (Legal Business Name): JAMES EDWARD STUBBS JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 W WILLIAM CANNON DR STE 145
AUSTIN TX
78745-5002
US

IV. Provider business mailing address

3421 W WILLIAM CANNON DR STE 145
AUSTIN TX
78745-5002
US

V. Phone/Fax

Practice location:
  • Phone: 512-358-0325
  • Fax: 602-952-2803
Mailing address:
  • Phone: 602-952-2802
  • Fax: 602-952-2803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7886
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: