Provider Demographics
NPI:1558410266
Name:JAMES J BOOP, M.D.,P.A.
Entity Type:Organization
Organization Name:JAMES J BOOP, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOOP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-792-0785
Mailing Address - Street 1:2719 81ST ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2229
Mailing Address - Country:US
Mailing Address - Phone:806-792-0785
Mailing Address - Fax:806-788-1620
Practice Address - Street 1:2719 81ST ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2229
Practice Address - Country:US
Practice Address - Phone:806-792-0785
Practice Address - Fax:806-788-1620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2993207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182252001Medicaid
TX0113PUOtherBLUE CROSS BLUE SHIELD
TX00W506Medicare PIN
TX0113PUOtherBLUE CROSS BLUE SHIELD