Provider Demographics
NPI:1962548321
Name:UNDERWOOD, JAMES MAXELL (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MAXELL
Last Name:UNDERWOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:4755 RIVER CREEK PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-2919
Mailing Address - Country:US
Mailing Address - Phone:915-241-5009
Mailing Address - Fax:915-595-0035
Practice Address - Street 1:10518 MONTWOOD DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-2703
Practice Address - Country:US
Practice Address - Phone:915-595-4471
Practice Address - Fax:915-595-0035
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor