=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689934135
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMES P MAGUIRE M D P A
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2012
-----------------------------------------------------
Last Update Date | 05/17/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3015 E MULBERRY ST
-----------------------------------------------------
City | ANGLETON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77515-2927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-849-2429
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3015 E MULBERRY ST
-----------------------------------------------------
City | ANGLETON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77515-2927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-849-2429
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICAN
-----------------------------------------------------
Name | DR. JAMES PATRICK MAGUIRE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 979-849-2429
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | J1300
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------