| Utmb Faculty Group Practice | |
|
950 Washington Blvd Beaumont TX 77705-2251 | |
| (409) 833-3826 | |
| (409) 833-9575 |
| Full Name | Utmb Faculty Group Practice |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 950 Washington Blvd, Beaumont, Texas |
| Authorized Official Name and Position | Cynthia L. Smith (DIRECTOR) |
| Authorized Official Contact | 4097722222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Utmb Faculty Group Practice P O Box 4797-710 Houston TX 77210-4797 Ph: (409) 772-2222 | Utmb Faculty Group Practice 950 Washington Blvd Beaumont TX 77705-2251 Ph: (409) 833-3826 |
| NPI Number | 1821039058 |
|---|---|
| Provider Enumeration Date | 06/09/2006 |
| Last Update Date | 09/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821039058 | NPI | - | NPPES |
| 112048704 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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