Provider Demographics
NPI:1578745907
Name:INMAN, JAMIE D (DO)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:D
Last Name:INMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 S HULEN ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4917
Mailing Address - Country:US
Mailing Address - Phone:817-926-4600
Mailing Address - Fax:817-927-4604
Practice Address - Street 1:4305 S HULEN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4917
Practice Address - Country:US
Practice Address - Phone:817-926-4600
Practice Address - Fax:817-927-4604
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0319207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00257902OtherMEDICARE RAILROAD
TX141927301Medicaid
TX8AJ269OtherBLUE CROSS
TX141845101Medicaid
TX00897MMedicare PIN