Provider Demographics
NPI:1356388870
Name:MACKEY, JAMES DAVID (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVID
Last Name:MACKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7415 LAS COLINAS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-7569
Mailing Address - Country:US
Mailing Address - Phone:214-379-2700
Mailing Address - Fax:214-869-3875
Practice Address - Street 1:431 E STATE HIGHWAY 114 STE 470
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-4415
Practice Address - Country:US
Practice Address - Phone:817-416-0202
Practice Address - Fax:817-869-3519
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2999207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174353601Medicaid
TX8K5253Medicare PIN
TXH96821Medicare UPIN