NPIMap

Organization Active NPI

Preventive Medicine of Southeast Texas, LLP

  • Family Medicine Physician
  • Beaumont, TX
National Provider Identifier
1013928290
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PREVENTIVE MEDICINE OF SOUTHEAST TEXAS, LLP
Practice address
5875 N Major Dr
Beaumont, TX 77713-9013
Phone
(409) 892-2262
Fax
(409) 899-8475
NPI assigned
Aug 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Howard D. Wilcox, M.D.
Title
Owner
Phone
(409) 892-2262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5875 N Major Dr
Beaumont, TX 77713-9013

Mailing address

5875 N Major Dr
Beaumont, TX 77713-9013
Phone (409) 892-2262

National Provider Directory

National Provider Directory

Locations

2965 Harrison Ave
Ste 218
Beaumont, TX 77702
Phone (409) 862-2262

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013928290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 N MAJOR DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777139013",
            "telephone_number": "409-892-2262",
            "fax_number": "409-899-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 N MAJOR DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777139013",
            "telephone_number": "409-892-2262",
            "fax_number": "409-899-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE MEDICINE OF SOUTHEAST TEXAS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILCOX",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-892-2262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.