Provider Demographics
NPI:1023150083
Name:CHILDS, JAMES NEUMANN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:NEUMANN
Last Name:CHILDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 ROCK PRAIRIE RD
Mailing Address - Street 2:STE 312
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845
Mailing Address - Country:US
Mailing Address - Phone:979-696-4444
Mailing Address - Fax:
Practice Address - Street 1:1605 ROCK PRAIRIE RD
Practice Address - Street 2:STE 312
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8358
Practice Address - Country:US
Practice Address - Phone:979-696-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1939207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83X580OtherBLUE CROSS BLUE SHIELD TX
TXF26635Medicare UPIN