Provider Demographics
NPI:1720138084
Name:AUSMUS, JAMES WAYNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WAYNE
Last Name:AUSMUS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2676 BERING DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-5740
Mailing Address - Country:US
Mailing Address - Phone:713-781-4383
Mailing Address - Fax:
Practice Address - Street 1:12724 WOODFOREST BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-2774
Practice Address - Country:US
Practice Address - Phone:713-453-3511
Practice Address - Fax:713-453-6955
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice