Healthcare Provider Details

I. General information

NPI: 1417068719
Provider Name (Legal Business Name): JAMES LAWYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1737 BRIARCREST DR SUITE 14
BRYAN TX
77802-2769
US

IV. Provider business mailing address

1737 BRIARCREST DR SUITE 14
BRYAN TX
77802-2769
US

V. Phone/Fax

Practice location:
  • Phone: 979-776-4777
  • Fax: 979-776-0588
Mailing address:
  • Phone: 979-776-4777
  • Fax: 979-776-0588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberL8106
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: