Provider Demographics
NPI:1770768756
Name:JAMES C. JEFFRIES, D.D.S., M.S. INC
Entity type:Organization
Organization Name:JAMES C. JEFFRIES, D.D.S., M.S. INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFRIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-465-8239
Mailing Address - Street 1:11451 KATY FWY STE 105
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2008
Mailing Address - Country:US
Mailing Address - Phone:713-465-8239
Mailing Address - Fax:713-465-5942
Practice Address - Street 1:11451 KATY FWY STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2008
Practice Address - Country:US
Practice Address - Phone:713-465-8239
Practice Address - Fax:713-465-5942
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAMES C. JEFFRIES, D.D.S., M.S. INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8540305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization