NPIMap

Organization Active NPI

Beaumont Internal Medicine & Geriatric Assoc.

  • Geriatric Medicine (Internal Medicine) Physician
  • Beaumont, TX
National Provider Identifier
1164430906
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
BEAUMONT INTERNAL MEDICINE & GERIATRIC ASSOC.
Practice address
755 N 11TH St
P-5200
Beaumont, TX 77702-1501
Phone
(409) 898-2994
Fax
(409) 899-5542
NPI assigned
Aug 4, 2006
Last updated
Dec 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Authorized official

Name
Dr. Santos Marcelo Soberon, M.D.NPI 1275540395
Title
President
Phone
(409) 898-2994

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

755 N 11TH St
P-5200
Beaumont, TX 77702-1501

Mailing address

755 N 11TH St
P-5200
Beaumont, TX 77702-1501
Phone (409) 898-2994

Other practice location 1

3129 College St Ste 100
Beaumont, TX 77701-4682
Phone (409) 898-2994

Other practice location 2

740 Hospital Dr Ste 160
Beaumont, TX 77701-4663
Phone (409) 898-2994

Other identifiers 1

IdentifierTypeStateIssuer
093730201MedicaidTX

Other names 1

  • GEORGE E THOMAS & ASSOC. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625000243 TX Part B Supplier - Clinic/Group Practice 9032195789 Receives reassigned benefits from 20 practitioners
Practice locations: Beaumont, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0899231Beaumont Internal Medicine & Geriatric Associates755 N 11TH St Suite P5200, Beaumont, TX 77702ComplianceJun 8, 2027
45D2181560Beaumont Internal Medicine & Geriactric Associates740 Hospital Drive Suite # 160, Beaumont, TX 77701Certificate of waiverApr 6, 2028
45D2335880Beaumont Internal Medicine & Geriatric Associates3129 College Street Suite 100, Beaumont, TX 77701Certificate of waiverDec 18, 2027

National Provider Directory

National Provider Directory

Locations

755 N 11th St
Ste P5200
Beaumont, TX 77702
Phone (409) 898-2193

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIAJAA

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767139200000",
    "number": "1164430906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "P-5200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021501",
            "telephone_number": "409-898-2994",
            "fax_number": "409-899-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "P-5200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021501",
            "telephone_number": "409-898-2994",
            "fax_number": "409-899-5542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3129 College St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777014682",
            "country_code": "US",
            "telephone_number": "409-898-2994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "740 Hospital Dr Ste 160",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777014663",
            "country_code": "US",
            "telephone_number": "409-898-2994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BEAUMONT INTERNAL MEDICINE & GERIATRIC ASSOC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A",
        "authorized_official_last_name": "SOBERON",
        "authorized_official_first_name": "SANTOS",
        "authorized_official_middle_name": "MARCELO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-898-2994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093730201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GEORGE E THOMAS & ASSOC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.