Individual
JIVIDEN JAMES MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2010 W KATHERINE P RAINES RD STE 300, CLEBURNE, TX 76033-7447
(817) 556-3212
Mailing address
2010 W KATHERINE P RAINES RD STE 300, CLEBURNE, TX 76033-7447
(325) 672-4372
(325) 673-0856
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA08350
TX
363AS0400X
Surgical Physician Assistant
PA08350
TX
Other
Enumeration date
03/12/2013
Last updated
04/18/2023
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