MEDICARE: DR. JAMES LOUIS WASSON MD, FACOG

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	207VE0102X	Reproductive Endocrinology Physician	J6274	TX
2	207VM0101X	Maternal & Fetal Medicine Physician	J6274	TX
3	207VX0000X	Obstetrics Physician	J6274	TX
4	207V00000X	Obstetrics & Gynecology Physician	J6274	TX
5	2471B0102X	Bone Densitometry Radiologic Technologist	J6274	TX
6	2471S1302X	Sonography Radiologic Technologist	J6274	TX
7	207VG0400X	Gynecology Physician	J6274	TX
8	207VC0200X	Critical Care Medicine (Obstetrics & Gynecology) Physician	J6274	TX
9	207VX0201X	Gynecologic Oncology Physician	J6274	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160059002	OTHER	TX	RAILROAD MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	61321	OTHER	TX	AMERIGROUP
3	8G2280	OTHER	TX	BLUECROSSBLUESHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598736829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES LOUIS WASSON MD, FACOG

Provider Business Mailing Address
First Line	:	837 S FLEISHEL AVE
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75701-2017
Country	:	US
Telephone Number	:	903-939-2273
Fax Number	:	903-581-2137

Provider Business Practice Location Address
First Line	:	837 S FLEISHEL AVE
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75701-2017
Country	:	US
Telephone Number	:	903-939-2273
Fax Number	:	903-581-2137

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	02/23/2026

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