Individual
JAMES J MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 GRACE LANE, AUSTIN, TX 78746
(512) 343-6067
Mailing address
500 GRACE LN, AUSTIN, TX 78746-4815
(512) 343-6067
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
G5347
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A36U
BLUE CROSS BLUE SHIELD
TX
05
—
P000A36U4
—
TX
Enumeration date
08/08/2006
Last updated
10/03/2024
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