Individual
JOHN HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4144 N CENTRAL EXPY, STE 700, DALLAS, TX 75204-3130
(214) 252-3501
Mailing address
4144 N CENTRAL EXPY, STE 700, DALLAS, TX 75204-3130
(214) 252-3501
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
H0480
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127836802
—
TX
05
—
127836807
—
TX
05
—
127836808
—
TX
05
—
190515002
—
TX
01
—
8BK799
BCBS
TX
01
—
8EH268
BCBS TX
TX
01
—
P00719219
RAILROAD
TX
Enumeration date
06/09/2005
Last updated
10/28/2015
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