Provider Demographics
NPI:1578628558
Name:PFISTER, JAMES GILBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GILBERT
Last Name:PFISTER
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 1:10218 MIDWAY RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-6231
Mailing Address - Country:US
Mailing Address - Phone:214-351-4084
Mailing Address - Fax:214-351-4492
Practice Address - Street 1:10218 MIDWAY RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-6231
Practice Address - Country:US
Practice Address - Phone:214-351-4084
Practice Address - Fax:214-351-4492
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7470207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH19933Medicare UPIN