Provider Demographics
NPI:1699231852
Name:DOTSON, JAMES EARL JR
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EARL
Last Name:DOTSON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 N SAM HOUSTON PKWY E STE 155
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-4061
Mailing Address - Country:US
Mailing Address - Phone:832-943-4035
Mailing Address - Fax:
Practice Address - Street 1:519 N SAM HOUSTON PKWY E STE 155
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4061
Practice Address - Country:US
Practice Address - Phone:832-943-4035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX373188702Medicaid