Provider Demographics
NPI:1114998937
Name:JAMES, THERESSA LORETTA (MD)
Entity Type:Individual
Prefix:
First Name:THERESSA
Middle Name:LORETTA
Last Name:JAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9750 LEVIN RD NW
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8399
Mailing Address - Country:US
Mailing Address - Phone:360-307-7202
Mailing Address - Fax:306-986-6600
Practice Address - Street 1:7121 S PADRE ISLAND DR STE 302
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4941
Practice Address - Country:US
Practice Address - Phone:361-851-5000
Practice Address - Fax:361-851-8053
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60801789207V00000X
TXM6807207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8993761OtherMEDICARE
TX188037901Medicaid
TXE97451Medicare UPIN