1558460543 NPI number — DR. TERRY L JAMES MD PA

Table of content: DR. TERRY L JAMES MD PA (NPI 1558460543)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558460543 NPI number — DR. TERRY L JAMES MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JAMES
Provider First Name:
TERRY
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD PA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558460543
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1450
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCKINNEY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-562-0028
Provider Business Mailing Address Fax Number:
972-562-9466

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 FOREST LANE
Provider Second Line Business Practice Location Address:
MEDICAL CITY DALLAS HOSPITAL
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-562-0028
Provider Business Practice Location Address Fax Number:
972-562-9466
Provider Enumeration Date:
09/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  E5391 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P000AJ828 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0042GU . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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