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:
Health care specialties
Specialty | Code | License # | 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 6 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1457324782 | NPPES |
Other | 8AH949 | BLUE CROSS |
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