Healthcare Provider Details
I. General information
NPI: 1033176029
Provider Name (Legal Business Name): JAMES A MIXON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/26/2006
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2692 W WALNUT ST STE 101
GARLAND TX
75042-6417
US
IV. Provider business mailing address
8301 LAKEVIEW PKWY SUITE 111-275
ROWLETT TX
75088-9320
US
V. Phone/Fax
- Phone: 972-272-4232
- Fax: 972-272-4247
- Phone: 972-272-4232
- Fax: 972-272-4247
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 9902 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: