Organization Active NPI

James H Demberg MD PA

  • Clinic/Center
  • Tyler, TX
National Provider Identifier
1770613945
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
F - 3096 Issued in TX
Legal business name
JAMES H DEMBERG MD PA
Practice address
1810 Shiloh Rd
Suite # 501
Tyler, TX 75703-2419
Phone
(903) 596-4600
NPI assigned
Mar 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. James H. Demberg, MD
Title
Owner
Phone
(903) 596-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X F - 3096 TX Primary

Addresses

Primary practice location

1810 Shiloh Rd
Suite # 501
Tyler, TX 75703-2419

Mailing address

PO Box 133170
Tyler, TX 75713-3170
Phone (903) 596-4600

National Provider Directory

National Provider Directory

Locations

1028 E Idel St
#B
Tyler, TX 75701
Phone (903) 533-8702

1810 Shiloh Rd
Ste 501
Tyler, TX 75703
Phone (903) 561-0060

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770613945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 133170",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757133170",
            "telephone_number": "903-596-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 SHILOH RD",
            "address_2": "SUITE # 501",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032419",
            "telephone_number": "903-596-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES H DEMBERG MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEMBERG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-596-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "F - 3096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.