Provider Demographics
NPI:1568450948
Name:KEMPER, JAMES VARDAMAN (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:VARDAMAN
Last Name:KEMPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 BALCONES DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4252
Mailing Address - Country:US
Mailing Address - Phone:512-836-8786
Mailing Address - Fax:512-836-8794
Practice Address - Street 1:5750 BALCONES DR
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4252
Practice Address - Country:US
Practice Address - Phone:512-836-8786
Practice Address - Fax:512-836-8794
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2122207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX104010704Medicaid
TX8CS725OtherBCBS
TX8C0380Medicaid
TXF52280Medicare UPIN
TX8645N0Medicare ID - Type Unspecified
TXTXB129903Medicare PIN