MEDICARE: JAMES W OSTERWISE D.C.

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	111NI0900X	Internist Chiropractor	6097	TX

General Provider Information

NPI Number	:	1043415193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES W OSTERWISE D.C.

Provider Business Mailing Address
First Line	:	2321 COIT RD
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-3794
Country	:	US
Telephone Number	:	972-519-1618
Fax Number	:	972-519-0121

Provider Business Practice Location Address
First Line	:	2321 COIT RD
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-3794
Country	:	US
Telephone Number	:	972-519-1618
Fax Number	:	972-519-0121

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

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	07/08/2007

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