Healthcare Provider Details

I. General information

NPI: 1477007110
Provider Name (Legal Business Name): DR. JAMES DONALD KEARNS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2016
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2954 CARRINGTON RD
FORT BLISS TX
79916
US

IV. Provider business mailing address

2954 CARRIGNTON RD
FORT BLISS TX
79916
US

V. Phone/Fax

Practice location:
  • Phone: 915-742-2685
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number41299
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number019030800
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019030800
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: