Healthcare Provider Details

I. General information

NPI: 1053329623
Provider Name (Legal Business Name): JAMES JOSEPH HEPTIG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 04/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5904 CHAPEL HILL BLVD SUITE 210
PLANO TX
75093-5925
US

IV. Provider business mailing address

5904 CHAPEL HILL BLVD SUITE 210
PLANO TX
75093-5925
US

V. Phone/Fax

Practice location:
  • Phone: 972-608-4411
  • Fax: 972-608-4412
Mailing address:
  • Phone: 972-608-4411
  • Fax: 972-608-4412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8764
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: