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1310 Interstate 10 S Beaumont TX 77707-4400 | |
| (409) 203-3107 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Case Management |
| Location | 1310 Interstate 10 S, Beaumont, Texas |
| Authorized Official Name and Position | William Harvey (OWNER) |
| Authorized Official Contact | 5754303990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12605 East Fwy Ste 308 Houston TX 77015-5646 Ph: () - | 1310 Interstate 10 S Beaumont TX 77707-4400 Ph: (409) 203-3107 |
| NPI Number | 1982420147 |
|---|---|
| Provider Enumeration Date | 12/03/2024 |
| Last Update Date | 12/03/2024 |
| Certification Date | 12/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982420147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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