| Beaumont Psychiatric Clinic | |
|
3560 Delaware St Ste 207 Beaumont TX 77706-3059 | |
| (409) 291-7622 | |
| (409) 292-2100 |
| Full Name | Beaumont Psychiatric Clinic |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3560 Delaware St Ste 207, Beaumont, Texas |
| Authorized Official Name and Position | Jason Osei Mensah (CEO/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4092917622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beaumont Psychiatric Clinic 3560 Delaware St Ste 207 Beaumont TX 77706-3059 Ph: (409) 291-7622 | Beaumont Psychiatric Clinic 3560 Delaware St Ste 207 Beaumont TX 77706-3059 Ph: (409) 291-7622 |
| NPI Number | 1225572555 |
|---|---|
| Provider Enumeration Date | 12/06/2016 |
| Last Update Date | 02/22/2023 |
| Certification Date | 02/22/2023 |
| Medicare PECOS PAC ID | 8426331141 |
|---|---|
| Medicare Enrollment ID | O20170203000336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225572555 | NPI | - | NPPES |
| Provider Name | Jason Mensah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619137593 PECOS PAC ID: 5395879696 Enrollment ID: I20150409001249 |
| Provider Name | Caralyn J Floyd |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477865459 PECOS PAC ID: 7517193980 Enrollment ID: I20151228000256 |
| Provider Name | Bridgett Fisk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548889116 PECOS PAC ID: 6709217862 Enrollment ID: I20200506000999 |
| Provider Name | Ashley Nichole Simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851053565 PECOS PAC ID: 3870974082 Enrollment ID: I20220719003858 |
| Provider Name | Robert Troy Polk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982287314 PECOS PAC ID: 1052795689 Enrollment ID: I20220831002492 |
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