Healthcare Provider Details

I. General information

NPI: 1447308010
Provider Name (Legal Business Name): DR. JAMES D GEDDES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 12/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 GENERAL CAVAZOS BLVD SUITE F
KINGSVILLE TX
78363-7129
US

IV. Provider business mailing address

1311 GENERAL CAVAZOS BLVD SUITE F
KINGSVILLE TX
78363-7129
US

V. Phone/Fax

Practice location:
  • Phone: 361-592-5284
  • Fax: 361-592-1677
Mailing address:
  • Phone: 361-592-5284
  • Fax: 361-592-1677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG1906
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: