Provider Demographics
NPI:1073524971
Name:HRACHOVY, JAMES J (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:HRACHOVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 HIGHWAY 71 S
Mailing Address - Street 2:101
Mailing Address - City:COLUMBUS
Mailing Address - State:TX
Mailing Address - Zip Code:78934-3011
Mailing Address - Country:US
Mailing Address - Phone:979-732-2318
Mailing Address - Fax:979-732-2310
Practice Address - Street 1:2122 HIGHWAY 71 S
Practice Address - Street 2:101
Practice Address - City:COLUMBUS
Practice Address - State:TX
Practice Address - Zip Code:78934-3011
Practice Address - Country:US
Practice Address - Phone:979-732-2318
Practice Address - Fax:979-732-2310
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD2464207P00000X, 207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX458608Medicare ID - Type UnspecifiedCLINIC BILLING
TXB23609Medicare UPIN
TX00030QMedicare Oscar/Certification