Provider Demographics
NPI:1215926878
Name:PURPURA, JAMES JOSEPH (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:PURPURA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5409
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-5409
Mailing Address - Country:US
Mailing Address - Phone:325-793-5290
Mailing Address - Fax:325-793-5220
Practice Address - Street 1:1665 ANTILLEY RD STE 260
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5249
Practice Address - Country:US
Practice Address - Phone:325-793-5290
Practice Address - Fax:325-793-5187
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8479207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166814701Medicaid
TX8C1138Medicare PIN
TX8C1138Medicare ID - Type Unspecified