Provider Demographics
NPI:1023119716
Name:JAMES, JEFFREE AUGUSTA (MD)
Entity type:Individual
Prefix:
First Name:JEFFREE
Middle Name:AUGUSTA
Last Name:JAMES
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 1:3232 E MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78721-1043
Mailing Address - Country:US
Mailing Address - Phone:512-477-7076
Mailing Address - Fax:
Practice Address - Street 1:3232 EAST MARTIN LUTHER KING JR. BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78721-1043
Practice Address - Country:US
Practice Address - Phone:512-477-7076
Practice Address - Fax:512-477-5198
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8898207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1237364-02Medicaid
TX1237364-02Medicaid
TXC17397Medicare UPIN