Organization · NPI-2

Centerwell Senior Primary Care (Tx) PA

Internal Medicine · Beaumont, TX

NPI number1568085108
StatusActive
Last updated in NPPESOct 18, 2022

Details

NPI
1568085108
Entity type
Organization (NPI-2)
Legal business name
Centerwell Senior Primary Care (Tx) PA
Organization subpart
Yes
Enumeration date
May 18, 2020
Certification date
Oct 18, 2022
Last updated
Oct 18, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes
208D00000X General Practice––
207Q00000X Family Medicine––

Other names

  • Partners In Primary Care- Beaumont (Doing Business As)
  • Partners In Primary Care Ks, PA (Former Legal Business Name)
  • Partners In Primary Care Tx, PA (Former Legal Business Name)
  • Centerwell Senior Primary Care-Beaumont (Doing Business As)

Practice location

4886 Dowlen Rd
Beaumont, TX 77708-4828

Phone 409-273-7235 · Fax 833-749-0336

Mailing address

4700 Millenia Blvd Ste 650
Orlando, FL 32839-6013

Phone 407-447-7120 · Fax 407-770-0661

Authorized official

Angie Martinez
Senior Credentialing Professional
4074477120

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