Provider Demographics
NPI:1548930449
Name:POULSON, JAMES STRATTON (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STRATTON
Last Name:POULSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9233 CHURCH RD APT 111
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4973
Mailing Address - Country:US
Mailing Address - Phone:469-733-5138
Mailing Address - Fax:
Practice Address - Street 1:136 GLASS ST STE 140
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-6930
Practice Address - Country:US
Practice Address - Phone:424-777-2739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14883111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor