Provider Demographics
NPI:1619189230
Name:JEFFRIES, JAMES CARLEY (DDS,MS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CARLEY
Last Name:JEFFRIES
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11451 KATY FWY STE 105
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2008
Mailing Address - Country:US
Mailing Address - Phone:713-465-8239
Mailing Address - Fax:713-465-5942
Practice Address - Street 1:11451 KATY FWY STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2008
Practice Address - Country:US
Practice Address - Phone:713-465-8239
Practice Address - Fax:713-465-5942
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85401223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics