Basic Information
Provider Information
NPI: 1912962689
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CRESWELL
FirstName: JAMES
MiddleName: SENTER
NamePrefix: DR.
NameSuffix:  
Credential: M. D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1201 W 38TH ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787051006
CountryCode: US
TelephoneNumber: 5123241086
FaxNumber:  
Practice Location
Address1: 1201 W 38TH ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787051006
CountryCode: US
TelephoneNumber: 5123241086
FaxNumber: 5123241089
Other Information
ProviderEnumerationDate: 04/18/2006
LastUpdateDate: 08/06/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080N0001XG2352TXY Allopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine

No ID Information.


Home