Provider Demographics
NPI:1952407801
Name:LAYTON, JAMES EDWARD
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:LAYTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 MORGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-1808
Mailing Address - Country:US
Mailing Address - Phone:361-883-2216
Mailing Address - Fax:
Practice Address - Street 1:2617 MORGAN AVE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1808
Practice Address - Country:US
Practice Address - Phone:361-883-2216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FC0800X, 156FC0801X
TXN/A156FX1700X, 156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact Lens
Not Answered156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter
Not Answered156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularist
Not Answered156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX500634OtherBCBS NUMBER
TXMKW9SL63OtherOPTICARE
TX500634OtherBCBS NUMBER