Individual
DR. JAMES J LIVESAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1101 BATES AVE, STE P115, HOUSTON, TX 77030-2607
(832) 355-4900
(832) 355-3770
Mailing address
PO BOX 20345, HOUSTON, TX 77225-0345
(832) 355-4900
(832) 355-3770
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
E1025
TX
2086S0129X
Vascular Surgery Physician
E1025
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
E1025
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136034904
—
TX
01
—
136034912
MEDICAID (STMC)
TX
01
—
330002572
TRAVELERS MEDICARE
TX
01
—
780000017
RAILROAD MEDICARE
TX
01
—
82C342
BCBS
TX
01
—
8DJ144
BCBS (STMC)
TX
01
—
B156290
MEDICARE (STMC)
TX
Enumeration date
10/06/2006
Last updated
12/09/2016
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