Provider Demographics
NPI:1447394630
Name:FIKES, JAMES PERRY (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PERRY
Last Name:FIKES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N LOOP 1604 E STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1246
Mailing Address - Country:US
Mailing Address - Phone:210-496-3869
Mailing Address - Fax:210-402-0025
Practice Address - Street 1:400 N LOOP 1604 E STE 205
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1246
Practice Address - Country:US
Practice Address - Phone:210-496-3869
Practice Address - Fax:210-402-0025
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX136101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice