Provider Demographics
NPI:1811108731
Name:MCCRARY, JAMES EDWARD (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:MCCRARY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:515 OLIVIA
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-2047
Mailing Address - Country:US
Mailing Address - Phone:210-833-9252
Mailing Address - Fax:210-223-2689
Practice Address - Street 1:515 OLIVIA
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2047
Practice Address - Country:US
Practice Address - Phone:210-833-9252
Practice Address - Fax:210-223-2689
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5233207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine