Individual
JAMES THOMAS WASHBURN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
1301 S PARKWAY DR, ALVARADO, TX 76009-8201
(817) 783-6940
Mailing address
1301 S PARKWAY DR, ALVARADO, TX 76009-8201
(817) 783-6940
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4931
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT4931
TDLR
TX
Enumeration date
05/28/2020
Last updated
05/28/2020
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