Provider Demographics
NPI:1063452019
Name:KAUFMAN, JAMES KEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KEVIN
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W HARWOOD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3163
Mailing Address - Country:US
Mailing Address - Phone:817-377-0143
Mailing Address - Fax:817-377-0173
Practice Address - Street 1:501 W HARWOOD RD STE 100
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3163
Practice Address - Country:US
Practice Address - Phone:817-377-0143
Practice Address - Fax:817-377-0173
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0318207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046445501Medicaid
TX8826J1Medicare ID - Type Unspecified
TXTXB138267Medicare PIN
TX046445501Medicaid
TXTXB129476Medicare PIN