Provider Demographics
NPI:1285639419
Name:SORCE, JAMES JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:SORCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:28505 SHAILENE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-1446
Mailing Address - Country:US
Mailing Address - Phone:956-648-1119
Mailing Address - Fax:
Practice Address - Street 1:801 STEVE HAWKINS PKWY
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-6303
Practice Address - Country:US
Practice Address - Phone:830-992-2830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1070207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX109800OtherSUPERIOR HEALTH PLANS
TX8454J3OtherBC/BS TX NUMBER
TX130520301Medicaid
TX176590500OtherWORKERS COMPENSATION
TX040010464OtherRAILROAD MEDICARE
TX130520307OtherCIDC
TX134649100OtherVALLEY HEALTH PLANS NUMBE
TX134649100OtherVALLEY HEALTH PLANS NUMBE
TX130520307OtherCIDC