MEDICARE: JAMES L DIRTING MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	G8084	TX
2	207L00000X	Anesthesiology Physician	G8084	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8EH555	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1164426409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES L DIRTING MD

Provider Business Mailing Address
First Line	:	PO BOX 840853
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-0853
Country	:	US
Telephone Number	:	972-233-1999
Fax Number	:	972-233-3999

Provider Business Practice Location Address
First Line	:	6606 LBJ FWY
Second Line	:	SUITE 200
City	:	DALLAS
State	:	TX
Zip	:	75240
Country	:	US
Telephone Number	:	972-715-5000
Fax Number	:	972-715-9976

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	06/06/2018

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Directions to “ JAMES L DIRTING MD” Practice Location

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