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General NPI Number Information
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NPI Number | 1396821997
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Entity Type | Individual
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Provider Name | JAMES RALPH VANDERBURG III M. D.
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Gender | Male
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 04/15/2020
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Provider Practice Location Address
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Address Line | 2701 US HIGHWAY 271 N
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City | PITTSBURG
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State | TX
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Zip | 75686-4289
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Country | US
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Telephone | 903-946-5442
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Fax | 903-946-5258
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Provider Business Mailing Address
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Address Line | 2701 US HIGHWAY 271 N STE 301
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City | PITTSBURG
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State | TX
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Zip | 75686-4289
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Country | US
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Telephone | 903-465-4429
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Fax | 903-946-5258
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | K9689
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License Number State | TX
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