Provider Demographics
NPI:1568538221
Name:DENNINGTON, JAMES ALAN (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALAN
Last Name:DENNINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:630 N KIMBALL AVE
Mailing Address - Street 2:STE #100
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-9255
Mailing Address - Country:US
Mailing Address - Phone:817-421-8777
Mailing Address - Fax:817-421-4388
Practice Address - Street 1:630 N KIMBALL AVE
Practice Address - Street 2:STE#100
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-9255
Practice Address - Country:US
Practice Address - Phone:817-421-8777
Practice Address - Fax:817-421-4388
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2014-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM7942207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350791ZGUYMedicare PIN