Provider Demographics
NPI:1255336996
Name:BROMLEY, JAMES M (MD,MPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:BROMLEY
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 SAN PEDRO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-2247
Mailing Address - Country:US
Mailing Address - Phone:210-732-5100
Mailing Address - Fax:210-732-5108
Practice Address - Street 1:3202 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-2247
Practice Address - Country:US
Practice Address - Phone:210-732-5100
Practice Address - Fax:210-732-5108
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9604207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX104196404Medicaid
TX3218486OtherAETNA HMO
TX41983BOtherAETNA
TX8J5600OtherBLUE CROSS/BLUE SHIELD
TX104196404Medicaid