Provider Demographics
NPI:1194950055
Name:JALOWY, JAMES J (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:JALOWY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 456
Mailing Address - Street 2:
Mailing Address - City:EAST BERNARD
Mailing Address - State:TX
Mailing Address - Zip Code:77435
Mailing Address - Country:US
Mailing Address - Phone:979-335-4825
Mailing Address - Fax:979-335-6076
Practice Address - Street 1:901 CLUBSIDE DR.
Practice Address - Street 2:
Practice Address - City:EAST-BERNARD
Practice Address - State:TX
Practice Address - Zip Code:77435
Practice Address - Country:US
Practice Address - Phone:979-335-4825
Practice Address - Fax:979-335-6076
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8293122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist