Provider Demographics
NPI:1568541928
Name:MULLOWNEY, JAMES (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MULLOWNEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 N GALLOWAY AVE
Mailing Address - Street 2:#108
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-5713
Mailing Address - Country:US
Mailing Address - Phone:972-289-5316
Mailing Address - Fax:972-289-5316
Practice Address - Street 1:2110 N GALLOWAY AVE
Practice Address - Street 2:#108
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-5713
Practice Address - Country:US
Practice Address - Phone:972-289-5316
Practice Address - Fax:972-289-5316
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2010-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3628207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0926867-01Medicaid
TXH3628OtherMEDICAL LICENSE
TXH3628OtherMEDICAL LICENSE