Provider Demographics
NPI:1467048371
Name:MCQUEEN, JAMES MICHAEL
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:MCQUEEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5037B FM 2920 RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-3114
Mailing Address - Country:US
Mailing Address - Phone:281-453-7085
Mailing Address - Fax:
Practice Address - Street 1:2306 RAYFORD RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-1707
Practice Address - Country:US
Practice Address - Phone:281-453-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist