Provider Demographics
NPI:1821155417
Name:HART, JAMES I (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:I
Last Name:HART
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 W HENDERSON
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033
Mailing Address - Country:US
Mailing Address - Phone:817-774-9800
Mailing Address - Fax:817-556-4600
Practice Address - Street 1:735 HWY 377 E
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048
Practice Address - Country:US
Practice Address - Phone:817-279-0558
Practice Address - Fax:817-573-2450
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1904152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX38775OtherSUPERIOR
024932OtherLOC
47721OtherDAVIS INS
919802OtherBLOCK
228OtherWALMART
454333OtherNVA
580627OtherBC & BS
979802OtherBLOCK
TX23573OtherSPECTERA
371OtherWALMART
019246OtherLOC