Provider Demographics
NPI:1518938828
Name:JAMES, LARRY WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:WAYNE
Last Name:JAMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11770 JOLLYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-3938
Mailing Address - Country:US
Mailing Address - Phone:512-331-5118
Mailing Address - Fax:512-331-5192
Practice Address - Street 1:11770 JOLLYVILLE RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3938
Practice Address - Country:US
Practice Address - Phone:512-331-5118
Practice Address - Fax:512-331-5192
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE7124207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC17394Medicare UPIN