Provider Demographics
NPI:1942226618
Name:BOONE, JAMES B III (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:BOONE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:6606 LBJ FWY
Practice Address - Street 2:STE. 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL6799207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165706601Medicaid
TX165706602Medicaid
TX0037LSOtherBCBS
TX8R1206OtherBCBS
I08929Medicare UPIN
TX8G2891Medicare PIN
TXP00140364Medicare PIN
TX165706601Medicaid
TX610726Medicare PIN