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General NPI Number Information
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NPI Number | 1669530267
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Entity Type | Individual
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Provider Name | KEVIN BERNARD JAMES M. D.
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 261 W SOUTHLAKE BLVD
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City | SOUTHLAKE
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State | TX
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Zip | 76092-7046
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Country | US
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Telephone | 817-310-8783
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Fax | 855-640-3872
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Provider Business Mailing Address
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Address Line | 101 CLEARY CT
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City | SOUTHLAKE
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State | TX
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Zip | 76092-2315
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Country | US
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Telephone | 214-502-9340
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Fax | 855-640-3872
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | M4201
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | M4201
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License Number State | TX
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