MEDICARE: JAMES KEVIN ELDRIDGE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	L3957	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110237224	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467491803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES KEVIN ELDRIDGE M.D.

Provider Business Mailing Address
First Line	:	800 5TH AVE
Second Line	:	SUITE 300
City	:	FORT WORTH
State	:	TX
Zip	:	76104-7300
Country	:	US
Telephone Number	:	817-334-1400
Fax Number	:	817-334-1410

Provider Business Practice Location Address
First Line	:	500 S HENDERSON ST STE 460
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2155
Country	:	US
Telephone Number	:	817-250-7441
Fax Number	:	817-250-0135

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	04/02/2026

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