Individual
JAMES ELWOOD PICKETT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2430 S IH 35 STE 106, SAN MARCOS, TX 78666-5921
(512) 353-1300
(512) 353-5135
Mailing address
1300 WONDER WORLD DR, SAN MARCOS, TX 78666-7575
(512) 353-1300
(512) 353-5135
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G3694
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120321802
—
TX
01
—
742732278
TAX ID
TX
01
—
85X691
BCBS
TX
Enumeration date
08/25/2006
Last updated
10/28/2020
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