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General NPI Number Information
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NPI Number | 1306005582
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Entity Type | Organization
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Legal Business Name | JIM P HUSSEY DOPA
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 399 W CAMPBELL RD STE 204
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City | RICHARDSON
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State | TX
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Zip | 75080-3606
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Country | US
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Telephone | 972-234-8868
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Fax | 972-234-8466
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Provider Business Mailing Address
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Address Line | 399 W CAMPBELL RD STE 204
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City | RICHARDSON
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State | TX
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Zip | 75080-3606
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Country | US
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Telephone | 972-234-8868
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Fax | 972-234-8466
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JIM PASCAL HUSSEY
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Credential | D.O.
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Telephone | 972-234-8868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F3181
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License Number State | TX
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