MEDICARE: GEORGE JAMES M.D.

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	207RC0000X	Cardiovascular Disease Physician	M1791	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

General Provider Information

NPI Number	:	1629054184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE JAMES M.D.

Provider Business Mailing Address
First Line	:	1900 MISTLETOE BLVD
Second Line	:	SUITE 100
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4014
Country	:	US
Telephone Number	:	817-338-1300
Fax Number	:	817-335-9871

Provider Business Practice Location Address
First Line	:	4900 BOAT CLUB RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76135-1802
Country	:	US
Telephone Number	:	817-338-1300
Fax Number	:

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

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	09/16/2020

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