MEDICARE: JAMES J BAUGHMAN PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1057816	TX

General Provider Information

NPI Number	:	1932861580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES J BAUGHMAN PMHNP-BC

Provider Business Mailing Address
First Line	:	100 INDEPENDENCE PL STE 307
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-1328
Country	:	US
Telephone Number	:	430-288-5800
Fax Number	:	800-797-3780

Provider Business Practice Location Address
First Line	:	100 INDEPENDENCE PL STE 307
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-1328
Country	:	US
Telephone Number	:	430-288-5800
Fax Number	:	800-797-3780

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

Provider Enumeration Date	:	10/12/2021
Last Update Date	:	07/22/2025

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