Provider Demographics
NPI:1700813904
Name:MAGUIRE, JAMES PATRICK (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PATRICK
Last Name:MAGUIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3015 E MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-2927
Mailing Address - Country:US
Mailing Address - Phone:979-849-2429
Mailing Address - Fax:979-849-0429
Practice Address - Street 1:3015 E. MULBERRY STREET
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515
Practice Address - Country:US
Practice Address - Phone:979-849-2429
Practice Address - Fax:979-849-0429
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1300208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033806301Medicaid
TXFO8755Medicare UPIN
TX033806301Medicaid