Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 1-07627-3 | TX |
NPI | 1023189412 |
---|---|
Provider Name | Dr. James A Archambeau |
First Address | Richardson, TX 75080-4154 |
Second Address | Richardson, TX 75080-4154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2006 |
Last Update Date | 08/07/2007 |