Provider Demographics
NPI:1942268586
Name:RACE, JAMES E
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:RACE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:E
Other - Last Name:RACE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD,
Mailing Address - Street 1:2909 S HAMPTON RD
Mailing Address - Street 2:#E220
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224
Mailing Address - Country:US
Mailing Address - Phone:214-467-3832
Mailing Address - Fax:214-467-3380
Practice Address - Street 1:2909 S HAMPTON RD
Practice Address - Street 2:#E220
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-3000
Practice Address - Country:US
Practice Address - Phone:214-467-3832
Practice Address - Fax:214-467-3380
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5039207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130976701Medicaid
TXTXB161375Medicare PIN
TX00A37QMedicare PIN