Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | L5172 | TX |
N | 207PP0204X | Pediatric Emergency Physician | L5172 | TX |
NPI | 1316927577 |
---|---|
Provider Name | James S Vincent |
First Address | Houston, TX 77216-0993 |
Second Address | Alvin, TX 77511-5542 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2006 |
Last Update Date | 12/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1316927577 | TRICARE SOUTH (01) | TX |
164913904 | (05) | TX |
164913905 | (05) | TX |
164913906 | (05) | TX |
8G6289 | BC/BS PROVIDER NUMBER (01) | TX |
H81014 | (02) | TX |