Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | BP10050375 | TX |
NPI | 1013322619 |
---|---|
Provider Name | James Carr |
First Address | Dallas, TX 75284-1656 |
Second Address | Tyler, TX 75701-2036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2014 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
374034201 | (05) | TX |
426521YMAF | MEDICARE (01) | TX |
587074YS6P | MEDICARE (01) | TX |
75-0818167-015 | TRICARE (01) | TX |
75-0818167-044 | TRICARE (01) | TX |
75-0818167-048 | TRICARE (01) | TX |
75-0818167-051 | TRICARE (01) | TX |
75-1976930-005 | TRICARE (01) | TX |
8GY074 | BCBS (01) | TX |
P01878578 | MEDICARE RAIL ROAD (01) | TX |
P01878810 | MEDICARE RAIL ROAD (01) | TX |