Provider Demographics
NPI:1962472449
Name:PURGASON, JAMES GILLIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GILLIS
Last Name:PURGASON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2601 SCRIPTURE ST
Mailing Address - Street 2:STE. 102
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-4321
Mailing Address - Country:US
Mailing Address - Phone:940-442-6455
Mailing Address - Fax:940-442-6606
Practice Address - Street 1:2601 SCRIPTURE ST
Practice Address - Street 2:STE. 102
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4321
Practice Address - Country:US
Practice Address - Phone:940-442-6455
Practice Address - Fax:940-442-6606
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2010-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6672207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX040231501Medicaid
TX040231501Medicaid
TX8226K3Medicare ID - Type Unspecified