Beaumont Retina Consultant PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

BEAUMONT RETINA CONSULTANT PA

Practice address

740 Hospital Dr
Suite 200
Beaumont, TX 77701-4664

Phone

(409) 832-8883

Fax

(409) 833-5755

NPI assigned

Nov 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Graham Douglas Avery, MDNPI 1285666024

Title

Owner

Phone

(409) 832-8883

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Graham Douglas Avery, MD

  • Ophthalmology Physician
  • Beaumont, TX
  • NPI 1285666024
  NPD (past) Authorized official

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1114108677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 HOSPITAL DR",
            "address_2": "SUITE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014664",
            "telephone_number": "409-832-8883",
            "fax_number": "409-833-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 HOSPITAL DR",
            "address_2": "SUITE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014664",
            "telephone_number": "409-832-8883",
            "fax_number": "409-833-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT RETINA CONSULTANT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "AVERY",
        "authorized_official_first_name": "GRAHAM",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-832-8883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176154601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Beaumont Recovery and Consulting, Inc.
• Beaumont Smile Center, P.a.
• Beaumont Smiles Youth Dentistry, PLLC
• Beaumont SNF LLC
• Beaumont Speech and Language LLC
• Beaumont Spine Associates

• Ophthalmology Physician in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.