Provider Demographics
NPI:1013094515
Name:DRISCOLL, JAMES ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANDREW
Last Name:DRISCOLL
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 1:1305 W 34TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1922
Mailing Address - Country:US
Mailing Address - Phone:512-923-9553
Mailing Address - Fax:
Practice Address - Street 1:1305 W 34TH ST STE 400
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1922
Practice Address - Country:US
Practice Address - Phone:512-459-6599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2009-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006019872207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H85996Medicare UPIN
500708Medicare ID - Type Unspecified