Provider Demographics
NPI:1457730236
Name:EASLEY JAMES D
Entity Type:Organization
Organization Name:EASLEY JAMES D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIVATE PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:EASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-885-2767
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:SEALY
Mailing Address - State:TX
Mailing Address - Zip Code:77474-1239
Mailing Address - Country:US
Mailing Address - Phone:979-885-2767
Mailing Address - Fax:979-885-2767
Practice Address - Street 1:4712 FM 1094
Practice Address - Street 2:
Practice Address - City:SEALY
Practice Address - State:TX
Practice Address - Zip Code:77474
Practice Address - Country:US
Practice Address - Phone:979-885-2767
Practice Address - Fax:979-885-2767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8697174400000X, 261QX0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty