Provider Demographics
NPI:1558362236
Name:MCNALLY, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:MCNALLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:25 HIGHLAND PARK VLG
Mailing Address - Street 2:100-381
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-2789
Mailing Address - Country:US
Mailing Address - Phone:214-219-7320
Mailing Address - Fax:214-443-0838
Practice Address - Street 1:700 HIGHLANDER BLVD
Practice Address - Street 2:STE 415
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-4330
Practice Address - Country:US
Practice Address - Phone:817-516-8811
Practice Address - Fax:817-516-8444
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2013-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXE6515207L00000X
OK12296207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089931202Medicaid
00MR53Medicare ID - Type Unspecified
C19222Medicare UPIN