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Individual

JAMES A. CACCITOLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
703 S FLEISHEL AVE, STE 5000, TYLER, TX 75701-2015
(903) 606-7525
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
L7997
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
121217
SUPERIOR CHIPS
TX
05
165486503
TX
01
88869G
BCBS OF TEXAS
TX
01
TIN PLUS 039
TRICARE
TX
01
TIN PLUS 049
TRICARE
TX
Enumeration date
07/31/2006
Last updated
11/06/2024
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