Provider Demographics
NPI:1669530267
Name:JAMES, KEVIN BERNARD (M D)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:BERNARD
Last Name:JAMES
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CLEARY CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-2315
Mailing Address - Country:US
Mailing Address - Phone:214-502-9340
Mailing Address - Fax:855-640-3872
Practice Address - Street 1:261 W SOUTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7046
Practice Address - Country:US
Practice Address - Phone:817-310-8783
Practice Address - Fax:855-640-3872
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4201207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AR030OtherBCBS
TX194239301Medicaid
TX194239302Medicaid
TX8AR030OtherBCBS
TX8F7299Medicare PIN