MEDICARE: DR. JAMES E ANDERSON JR. 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	L9600	TX

General Provider Information

NPI Number	:	1245240290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES E ANDERSON JR. MD

Provider Business Mailing Address
First Line	:	900 W ROSEDALE ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4681
Country	:	US
Telephone Number	:	817-885-7442
Fax Number	:	817-885-7443

Provider Business Practice Location Address
First Line	:	900 W ROSEDALE ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4537
Country	:	US
Telephone Number	:	817-885-7442
Fax Number	:	817-885-7443

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	01/29/2025

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