Provider Demographics
NPI:1982896056
Name:HARKINS, JAMES PATRICK JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PATRICK
Last Name:HARKINS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2400 AMBASSADOR DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-9702
Mailing Address - Country:US
Mailing Address - Phone:254-756-4457
Mailing Address - Fax:
Practice Address - Street 1:2400 AMBASSADOR DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-9702
Practice Address - Country:US
Practice Address - Phone:254-756-4457
Practice Address - Fax:254-756-1718
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6344174400000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00876ROtherGROUP MEDICARE NUMBER
TX161488501Medicaid
TX161488501Medicaid