Provider Demographics
NPI:1386737120
Name:DEMBERG, JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:DEMBERG
Suffix:
Gender:M
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:P.O. BOX 6409
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-6409
Mailing Address - Country:US
Mailing Address - Phone:361-696-6200
Mailing Address - Fax:361-696-6054
Practice Address - Street 1:7121 S.P.I.D.
Practice Address - Street 2:SUITE 300
Practice Address - City:COPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4389
Practice Address - Country:US
Practice Address - Phone:361-696-6200
Practice Address - Fax:361-696-6054
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3096207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00097HOtherMEDICARE GROUP #
TX00097HOtherMEDICARE GROUP #
TX8L7634Medicare PIN