Provider Demographics
NPI:1275850836
Name:APPLEBURY, JAMES EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:APPLEBURY
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:PO BOX 132886
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75713-2886
Mailing Address - Country:US
Mailing Address - Phone:903-969-0143
Mailing Address - Fax:
Practice Address - Street 1:6546 WHEATON CT
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-4243
Practice Address - Country:US
Practice Address - Phone:903-969-0143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-22
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA121719208100000X
OK42156208100000X
390200000X
TXQ8692208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX404552801Medicaid
TX8LV008OtherBCBS