| Southeast Texas Medical Associates, Llp | |
|
2929 Calder St Ste 100 Beaumont TX 77702-1841 | |
| (409) 833-9797 | |
| (409) 654-6906 |
| Full Name | Southeast Texas Medical Associates, Llp |
|---|---|
| Speciality | Family Medicine |
| Location | 2929 Calder St, Beaumont, Texas |
| Authorized Official Name and Position | James L. Holly (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4098339797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Texas Medical Associates, Llp 2929 Calder St Suite 100 Beaumont TX 77702-1845 Ph: (409) 833-9797 | Southeast Texas Medical Associates, Llp 2929 Calder St Ste 100 Beaumont TX 77702-1841 Ph: (409) 833-9797 |
| NPI Number | 1922001312 |
|---|---|
| Provider Enumeration Date | 05/31/2005 |
| Last Update Date | 08/26/2016 |
| Medicare PECOS PAC ID | 1658281100 |
|---|---|
| Medicare Enrollment ID | O20040405000787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922001312 | NPI | - | NPPES |
| 084789901 | Medicaid | TX |
| Provider Name | Syed I Anwar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053314401 PECOS PAC ID: 5597661504 Enrollment ID: I20031210000651 |
| Provider Name | Vincent P Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851394100 PECOS PAC ID: 5597752758 Enrollment ID: I20040428001644 |
| Provider Name | Dana Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508868811 PECOS PAC ID: 4082602917 Enrollment ID: I20040430001290 |
| Provider Name | Miles K Sykes |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740282029 PECOS PAC ID: 1052395472 Enrollment ID: I20040615000242 |
| Provider Name | Julie A Mcclure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922000215 PECOS PAC ID: 6608823893 Enrollment ID: I20050330001235 |
| Provider Name | Alicia H Horn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558463562 PECOS PAC ID: 5597702076 Enrollment ID: I20050415000451 |
| Provider Name | Robert David Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366621500 PECOS PAC ID: 3072536903 Enrollment ID: I20060106000249 |
| Provider Name | Michael P Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801955349 PECOS PAC ID: 5597774059 Enrollment ID: I20060411000332 |
| Provider Name | William D George |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144229659 PECOS PAC ID: 0840290482 Enrollment ID: I20070105000231 |
| Provider Name | Vijay Kumar |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1972506236 PECOS PAC ID: 5496836942 Enrollment ID: I20080122000780 |
| Provider Name | Dipali S Patel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962667824 PECOS PAC ID: 5890862387 Enrollment ID: I20080925000272 |
| Provider Name | Elizabeth J Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093715443 PECOS PAC ID: 8527117167 Enrollment ID: I20090601000300 |
| Provider Name | Caesar Deiparine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174529408 PECOS PAC ID: 2961542006 Enrollment ID: I20091221000386 |
| Provider Name | Muhammad Aziz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437152873 PECOS PAC ID: 1456335876 Enrollment ID: I20100114000776 |
| Provider Name | Dean T Halbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497758767 PECOS PAC ID: 8820072242 Enrollment ID: I20100216000777 |
| Provider Name | Mary Jane Sunga Castro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942301130 PECOS PAC ID: 9234027459 Enrollment ID: I20100625000702 |
| Provider Name | Ronald Palang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518969500 PECOS PAC ID: 2466596903 Enrollment ID: I20100701000301 |
| Provider Name | Sandra Amen Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023010337 PECOS PAC ID: 2769515154 Enrollment ID: I20100805000657 |
| Provider Name | Norma Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326021858 PECOS PAC ID: 7719001056 Enrollment ID: I20100824000480 |
| Provider Name | Marcella Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487600227 PECOS PAC ID: 1456475722 Enrollment ID: I20100824000889 |
| Provider Name | Jeffrey Scott Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245286079 PECOS PAC ID: 4486779162 Enrollment ID: I20100917000933 |
| Provider Name | Girishkumar B Kansara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508873639 PECOS PAC ID: 3870620651 Enrollment ID: I20100920000963 |
| Provider Name | Absar Qureshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134270309 PECOS PAC ID: 9537268982 Enrollment ID: I20101104001582 |
| Provider Name | Phuc Nhat Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821235698 PECOS PAC ID: 7719152115 Enrollment ID: I20111214000384 |
| Provider Name | Kelly Darden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629342951 PECOS PAC ID: 2365698750 Enrollment ID: I20120820000539 |
| Provider Name | Julius Deiparine |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790892396 PECOS PAC ID: 8022054626 Enrollment ID: I20121016000191 |
| Provider Name | Melissa N Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245677673 PECOS PAC ID: 0749424851 Enrollment ID: I20130911000302 |
| Provider Name | Majaz Ali Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336175231 PECOS PAC ID: 4688566177 Enrollment ID: I20141231000930 |
| Provider Name | Jaweed Akhter |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1427002823 PECOS PAC ID: 4587830849 Enrollment ID: I20150107000229 |
| Provider Name | Courtney Kay Wagner-bijak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215389267 PECOS PAC ID: 3577858521 Enrollment ID: I20160830000657 |
| Provider Name | Justin Ryan Feldschau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396198669 PECOS PAC ID: 4587950183 Enrollment ID: I20160908000317 |
| Provider Name | Ignacio Mark Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962536086 PECOS PAC ID: 5193004182 Enrollment ID: I20161115001317 |
| Provider Name | Lydia L Bundick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316483092 PECOS PAC ID: 7911281795 Enrollment ID: I20170222001115 |
| Provider Name | Crystal Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154849529 PECOS PAC ID: 8123202363 Enrollment ID: I20171108000599 |
| Provider Name | Nicole Mcbryde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275033839 PECOS PAC ID: 4284995176 Enrollment ID: I20180312001267 |
| Provider Name | Marciana Castillo Tyler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346757168 PECOS PAC ID: 9133481823 Enrollment ID: I20180316000380 |
| Provider Name | Ashley Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386191393 PECOS PAC ID: 4688907736 Enrollment ID: I20190605001586 |
| Provider Name | Dawn Rita Polk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639659212 PECOS PAC ID: 8820427578 Enrollment ID: I20200401002747 |
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