Provider Demographics
NPI:1538252952
Name:NELSON, JAMES LANIER II (DPM)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LANIER
Last Name:NELSON
Suffix:II
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4412 50TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-3610
Mailing Address - Country:US
Mailing Address - Phone:806-795-8037
Mailing Address - Fax:806-799-6218
Practice Address - Street 1:4412 50TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-3610
Practice Address - Country:US
Practice Address - Phone:806-795-8037
Practice Address - Fax:806-799-6218
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0347213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81X531OtherBCBS
TX81X531OtherBCBS
TX81X531Medicare PIN