Provider Demographics
NPI:1992926547
Name:STRADER, JAMES DAVID (D O)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:STRADER
Suffix:
Gender:M
Credentials:D O
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 38
Mailing Address - Street 2:
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78163-0038
Mailing Address - Country:US
Mailing Address - Phone:830-980-2435
Mailing Address - Fax:
Practice Address - Street 1:2795 BULVERDE RD
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163-2195
Practice Address - Country:US
Practice Address - Phone:830-980-2435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor