Provider Demographics
NPI:1194768697
Name:SYFERD, JAMES LYN (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LYN
Last Name:SYFERD
Suffix:
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:PO BOX 479
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75030-0479
Mailing Address - Country:US
Mailing Address - Phone:972-475-3696
Mailing Address - Fax:
Practice Address - Street 1:8809 LAKEVIEW PKWY
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4555
Practice Address - Country:US
Practice Address - Phone:972-475-3696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5776111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208190701OtherTAX IDENTIFICATION
TX604511Medicare ID - Type Unspecified
TX208190701OtherTAX IDENTIFICATION