Provider Demographics
NPI:1073506697
Name:STUDT, JAMES L (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:STUDT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 22000
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76902-7200
Mailing Address - Country:US
Mailing Address - Phone:325-658-1511
Mailing Address - Fax:325-481-2166
Practice Address - Street 1:102 N MAGDALEN ST
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5400
Practice Address - Country:US
Practice Address - Phone:325-653-2010
Practice Address - Fax:325-658-8583
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2017-05-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG56642085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045623801Medicaid
TX00121NOtherBLUE CROSS
TX920004776OtherRAILROAD MEDICARE
TX920004776OtherRAILROAD MEDICARE
TXC68082Medicare UPIN