Provider Demographics
NPI:1336366848
Name:SUMMERS, JAMES S
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9813 MEMORIAL BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4253
Mailing Address - Country:US
Mailing Address - Phone:281-446-9157
Mailing Address - Fax:281-446-9555
Practice Address - Street 1:9813 MEMORIAL BLVD STE E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4253
Practice Address - Country:US
Practice Address - Phone:281-446-9157
Practice Address - Fax:281-446-9555
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117031223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics