Provider Demographics
NPI:1114967247
Name:ASH, JAMES BROOKSIE JR (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BROOKSIE
Last Name:ASH
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 LUTHER DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628
Mailing Address - Country:US
Mailing Address - Phone:512-868-6400
Mailing Address - Fax:512-868-6448
Practice Address - Street 1:109 LUTHER DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628
Practice Address - Country:US
Practice Address - Phone:512-868-6440
Practice Address - Fax:512-868-6448
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADC1303111N00000X
TX10384111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4C659Medicare ID - Type Unspecified
LAU94748Medicare UPIN