Provider Demographics
NPI:1669467056
Name:SARRETT, JAMES RANDALL (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RANDALL
Last Name:SARRETT
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 1:2101 GALLERIA OAKS DR
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-4625
Mailing Address - Country:US
Mailing Address - Phone:903-791-9120
Mailing Address - Fax:903-791-9132
Practice Address - Street 1:2101 GALLERIA OAKS DR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-4625
Practice Address - Country:US
Practice Address - Phone:903-791-9120
Practice Address - Fax:903-791-9132
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1657207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4995690001OtherCIGNA GOVERNMENT SERVICES
TX129619607Medicaid
TX4995690001OtherCIGNA GOVERNMENT SERVICES
8B4008Medicare PIN