Provider Demographics
NPI:1982427316
Name:WANJAMA, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:WANJAMA
Suffix:
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 1:3117 AUBURN COLONY CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4651
Mailing Address - Country:US
Mailing Address - Phone:972-374-7430
Mailing Address - Fax:
Practice Address - Street 1:3117 AUBURN COLONY CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4651
Practice Address - Country:US
Practice Address - Phone:972-374-7430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant