Organization · NPI-2

Beaumont Family Practice Associates PA

Family Medicine · Beaumont, TX

NPI number1629174891
StatusActive
Last updated in NPPESJun 29, 2016

Details

NPI
1629174891
Entity type
Organization (NPI-2)
Legal business name
Beaumont Family Practice Associates PA
Organization subpart
Yes
Enumeration date
Sep 15, 2006
Last updated
Jun 29, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineF1914TXYes

Other names

  • Southeast Texas Occupational Medicine (Doing Business As)

Practice location

6450 Folsom
Beaumont, TX 77706

Phone 409-835-0524 · Fax 409-833-2058

Mailing address

6450 Folsom
Beaumont, TX 77706

Phone 409-835-0524 · Fax 409-833-2058

Authorized official

Jay C Proctor
President/Owner
4098350524

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