Provider Demographics
NPI:1386036994
Name:JAMES, TALIA M (NP)
Entity Type:Individual
Prefix:MRS
First Name:TALIA
Middle Name:M
Last Name:JAMES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:TALIA
Other - Middle Name:M
Other - Last Name:HEIMERDINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 8574
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76124-0574
Mailing Address - Country:US
Mailing Address - Phone:817-451-4208
Mailing Address - Fax:817-563-3699
Practice Address - Street 1:18500 KATY FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1110
Practice Address - Country:US
Practice Address - Phone:817-451-4208
Practice Address - Fax:817-563-3699
Is Sole Proprietor?:No
Enumeration Date:2015-02-19
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX999999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily