Individual
DR. JAMES JOSEPH PETRIKAS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4708 ALLIANCE BLVD STE 150, PLANO, TX 75093-5339
(972) 596-7801
(972) 596-9307
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
125-042933
IL
2085R0001X
Radiation Oncology Physician
Primary
M4442
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181896501
—
TX
05
—
181896502
—
TX
05
—
181896503
—
TX
05
—
200123060A
—
OK
01
—
8W1133
BCBS
TX
Enumeration date
07/21/2006
Last updated
05/23/2019
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