Provider Demographics
NPI:1134268006
Name:WOLFF, JAMES DANIEL JR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DANIEL
Last Name:WOLFF
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1323 S 27TH ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-6294
Mailing Address - Country:US
Mailing Address - Phone:409-729-5400
Mailing Address - Fax:
Practice Address - Street 1:200 W. ARBOR DR
Practice Address - Street 2:MPF - L044
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8755
Practice Address - Country:US
Practice Address - Phone:619-543-7636
Practice Address - Fax:619-543-6923
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1026902085B0100X
OK238182085R0202X
TXN28862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2029530-01Medicaid
TX2029530-01Medicaid