Healthcare Provider Details

I. General information

NPI: 1447291158
Provider Name (Legal Business Name): JAMES ROBERT HERRIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N RIVERSHIRE DR SUITE # 190
CONROE TX
77304-0001
US

IV. Provider business mailing address

13276 CHAPPEL WOOD LN
CONROE TX
77302-3477
US

V. Phone/Fax

Practice location:
  • Phone: 936-788-6060
  • Fax: 936-788-6061
Mailing address:
  • Phone: 936-441-2314
  • Fax: 936-788-6061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE6094
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: