Basic Information
| Provider Information | |||||||||
| NPI: | 1881716983 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEAUMONT EMERGENCY MEDICINE ASSOCIATES PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9229 LYNDON B JOHNSON FWY | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752433405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003460747 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3080 COLLEGE ST | ||||||||
| Address2: | |||||||||
| City: | BEAUMONT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 777014606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4092125000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 11/06/2020 | ||||||||
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| AuthorizedOfficialLastName: | OSMAN | ||||||||
| AuthorizedOfficialFirstName: | ALI | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4096568715 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 11/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
No ID Information.