Provider Demographics
NPI:1659388163
Name:REMKUS, JAMES E (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:REMKUS
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 1:5 SANCTUARY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1666
Mailing Address - Country:US
Mailing Address - Phone:210-479-0200
Mailing Address - Fax:210-479-0205
Practice Address - Street 1:5 SANCTUARY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1666
Practice Address - Country:US
Practice Address - Phone:210-479-0200
Practice Address - Fax:210-479-0205
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNJ92982085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139084104Medicaid
TX541817395OtherEIN WITH OPENSIDED MRI OF SAN ANTONIO
TX00T06MMedicare PIN
TX541817395OtherEIN WITH OPENSIDED MRI OF SAN ANTONIO