Individual
DR. JAMES BLAKE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5251 W HIGHWAY 290, AUSTIN, TX 78735-8963
(512) 651-3000
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
H4385
TX
2086S0129X
Vascular Surgery Physician
Primary
H4385
TX
208C00000X
Colon & Rectal Surgery Physician
H4385
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131440301
—
TX
01
—
3202292
BLUELINK
TX
01
—
5849465
AETNA
TX
01
—
770001869
RAILROAD MEDICARE
TX
01
—
86Z402
BCBSTX
TX
01
—
MDH4385
TX WC/IHC
TX
Enumeration date
08/15/2005
Last updated
10/20/2021
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