Distefano, James S

Distefano, James S is an individual health care provider with primary practice located at 3201 University Dr E Ste 320 , Bryan TX 77802-3478. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Distefano, James S can be contacted via phone (979) 704-5029.

Contact Information

Primary practice address
3201 University Dr E Ste 320 Bryan TX 77802-3478
Phone: (979) 704-5029
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207PS0010X M7149 Texas

Profile Details

NPI number 1457324782
LBN Legal business name Distefano, James S
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Oct 10th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457324782 NPPES
Other 8AH949 BLUE CROSS

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