Basic Information
| Provider Information | |||||||||
| NPI: | 1851349286 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOOKER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | OVID | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 919 HIDDEN RDG | ||||||||
| Address2: | 6TH FLOOR | ||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750383813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4692822713 | ||||||||
| FaxNumber: | 4692822609 | ||||||||
| Practice Location | |||||||||
| Address1: | 1920 GALLERIA OAKS DR | ||||||||
| Address2: | |||||||||
| City: | TEXARKANA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 755034619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9037926114 | ||||||||
| FaxNumber: | 9037924266 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2006 | ||||||||
| LastUpdateDate: | 09/02/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | E22577 | TX | Y | Allopathic & Osteopathic Physicians | Surgery | 208600000X | E-7153 | AR | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | L6296 | TX | N | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 04030011900 | 01 | AR | QUALCHOICE | OTHER | 162942003 | 05 | TX | MEDICAID | 152101001 | 05 | AR | MEDICAID | P00065627 | 01 | TX | TRAVELERS MEDICARE | OTHER | 152101001 | 01 | AR | ARK. MEDICAID | OTHER | 162942001 | 05 | TX | MEDICAID | 200018260A | 01 | OK | OKLA MEDICAID | OTHER | 82678 | 01 | AR | AR BLUECROSS | OTHER | 8B1842 | 01 | TX | TEXAS BLUE CROSS | OTHER |