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General NPI Number Information
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NPI Number | 1669738522
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Entity Type | Individual
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Provider Name | JOBY THEKKUMKEL JAMES M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2012
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 4400 STATE HWY 121 STE 300 #1208
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City | LEWISVILLE
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State | TX
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Zip | 75056
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Country | US
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Telephone | 972-836-8145
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Fax | 904-621-6965
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Provider Business Mailing Address
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Address Line | 4400 STATE HWY 121 STE 300 #1208
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City | LEWISVILLE
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State | TX
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Zip | 75056
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Country | US
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Telephone | 972-836-8145
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Fax | 904-621-6965
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 29122
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R1548
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License Number State | TX
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