Provider Demographics
NPI:1124132782
Name:ANDERSON, JAMES FRANCIS (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FRANCIS
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:17711 KRUGERRAND DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5626
Mailing Address - Country:US
Mailing Address - Phone:210-653-5665
Mailing Address - Fax:210-590-2110
Practice Address - Street 1:8308 PAT BOOKER RD
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-2410
Practice Address - Country:US
Practice Address - Phone:210-653-5665
Practice Address - Fax:210-590-2110
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3562TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E98DMedicare ID - Type UnspecifiedMEDICARE UPIN/BCBSPROV.#