Provider Demographics
NPI:1114998937
Name:JAMES, THERESSA LORETTA (MD)
Entity type:Individual
Prefix:
First Name:THERESSA
Middle Name:LORETTA
Last Name:JAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 WESLEY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-9157
Mailing Address - Country:US
Mailing Address - Phone:361-816-6795
Mailing Address - Fax:
Practice Address - Street 1:7121 S PADRE ISLAND DR STE 302
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4941
Practice Address - Country:US
Practice Address - Phone:361-851-5000
Practice Address - Fax:361-851-8053
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM6807207V00000X
WAMD60801789207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188037901Medicaid
WAG8993761OtherMEDICARE
TXE97451Medicare UPIN