Individual
JAMES DWAYNE PICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
508 MEDICAL CENTER BLVD, STE 200, CONROE, TX 77304-2808
(936) 760-4600
(936) 760-4601
Mailing address
508 MEDICAL CENTER BLVD, STE 200, CONROE, TX 77304-2808
(936) 760-4600
(936) 760-4601
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
F7053
TX
207RI0011X
Interventional Cardiology Physician
Primary
F7053
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123004705
—
TX
Enumeration date
10/10/2006
Last updated
11/15/2012
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