1699774463 NPI number — DR. JAMES MICHAEL BLUHM DPM

Table of content: DR. JAMES MICHAEL BLUHM DPM (NPI 1699774463)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699774463 NPI number — DR. JAMES MICHAEL BLUHM DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BLUHM
Provider First Name:
JAMES
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
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:
1699774463
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1215 SANTA FE ST FL 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78404-2338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-371-3896
Provider Business Mailing Address Fax Number:
361-694-1478

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1215 SANTA FE ST FL 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78404-2338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-371-3896
Provider Business Practice Location Address Fax Number:
361-694-1478
Provider Enumeration Date:
07/14/2005

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: 213EP1101X , with the licence number:  1676 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0131X , with the licence number: 1676 , 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: 1712002 01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1796609 01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9360728 . This is a "PHCS PROVIDER #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1796609 02 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201525710 . This is a "COMMERCIAL INSURANCE ID #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0098LJ . This is a "BCBS OF TX PROVIDER ID #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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